PPACA Fails to Simplify Administrative Process

MARCH 15, 2013 – 12:04 PMImage

The Patient Protection and Affordable Care Act (PPACA) is failing to live up to a key promise that was made when the law was enacted in 2010 —simplifying the administrative process to obtain health insurance coverage through a state health benefits Exchange.

The U.S. Department of Health and Human Services (HHS) recently issued a draft of the paper application and a 60-page description of the online version earlier this week. While the White House has supported the law, claiming Exchanges, or “marketplaces,” will “help you find health insurance that fits your budget, with less hassle,” it is becoming increasingly clear that is not the case.

The application is only the beginning of a lengthy, convoluted application process. Once your application is sent to the Exchange, your information will be forwarded to the Data Services Hub, which will forward the information to several federal agencies, including Social Security for birth records, the IRS for income information, and Homeland Security to verify immigration status. The information that comes back from the government clearinghouse determines whether the applicant is eligible for subsidies. The federal agencies will then send that verified information back to the information hub which will then send approval notification back to the Exchange. The Exchange will then notify the applicant who may then select a plan, which will involve additional steps.

Concerns about privacy aside, critics are now worried the process is so complex it will overwhelm many applicants who will just give up.

The amount of time needed to complete the online application is estimated to be around a half hour, the paper version is estimated to take forty-five minutes according to the federal government. Ron Pollack, the executive director of Families USA, says, “This lengthy draft application will take a considerable amount of time to fill out and will be difficult for many people to complete.” Pollack is calling for the simplification of the form and increasing the number of Navigators that will be able to assist consumers in the application and selection process.

According to a statement by HHS spokeswoman Erin Shields Britt, the application is “being refined thanks to public input,” but argues it will still “help people make apples-to-apples comparisons of costs and coverage between health insurance plans and learn whether they can get a break in costs.”

Although PPACA may give the average consumer more information, it is still not ensuring that information is easy to understand. Clearly this is an area where Brokers could prove invaluable – not only in terms of their knowledge, but their ability to articulate complex insurance processes to consumers. For decades brokers have simplified the enrollment and payment process for millions of Americans. President Obama is making an error by excluding licensed brokers from the exchange process.

Author: Bernard DiFiore

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