Affordable Care Act: Open Enrollment 2014

Recent court rulings in Washington, D.C. and Virginia will make the upcoming open enrollment period in Florida and 35 other states that opted to allow the federal government to run their exchanges more interesting. The issue in question is whether a federally operated exchange can grant tax credits that are intended to make the purchase of Obamacare coverage affordable for those that qualify.

I am not an attorney so don’t expect me to give a legal analysis of the various claims and rulings. But the next open enrollment period at healthcare.gov starts November 15 and no attorney I’ve talked to thinks the conflicting rulings will be resolved by the Court of Appeals in the Fourth Circuit or the Supreme Court by then.

In the meantime, expect the subject to be written about extensively and don’t be surprised if it reaches a fever pitch just before the enrollment door opens once again. The war of words prior to and during the next open enrollment period could be as spirited as the campaign for Florida’s Governor.

Will opponents of the Affordable Care Act develop a campaign intended to dissuade the uninsured from applying for coverage through healthcare.gov using the questioned legality of tax credits as a deterrent? Proponents of the Act should anticipate such an attack and I suspect they are already planning a robust campaign to counter the expected negativity.

How unfortunate that the Centers for Medicare and Medicaid Services (CMS) may have hampered its positive messaging by adopting a start-stop-start approach to Navigator grant funding. The grant design established by CMS creates a gap in Navigator funds that will lead some organizations to gear down before they can gear up again if they are fortunate enough to win a second year of funding. Even so, there now exists an army of happy, newly insured Americans and the Navigators that got them there are likely to reach into those ranks to expand their outreach networks. They also have experience gained during the previous open enrollment period that will allow them to ramp up their efforts more quickly this time around.

With the legality of the tax credits unresolved, it will be business as usual during open enrollment with consumers qualifying for tax credits and enrolling in health care coverage at healthcare.gov. However, the questions that consumers ask Navigators may be quite different this year. I hope that Navigators do not try to help consumers compare the financial implication of possible tax credit repayment to the potential tax penalty for not enrolling in health care coverage. This is a question best left to insurance agents and tax professionals.

About The Author: Rose Naff currently serves as CEO of Florida Health Choices, Inc. and is building Florida’s Health Insurance Marketplace. Launched in 2014, the Marketplace can fill gaps in other healthcare coverage while additional phases are being built. Go to www.myfloridachoices.org to learn more.



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