CMS could boost ACA enrollment by letting consumers skip Healthcare.gov

Customers on the Affordable Care Act exchanges will be allowed to enroll directly on sites run by third-party brokers and insurers, rather than be redirected to Healthcare.gov, raising concerns from some group about privacy and choice for those shoppers.

CMS said the move “reduces needless regulatory burden” by allowing customers to complete their enrollment on a single website, rather than the “double redirect” that sent them from a broker or insurer’s site to HealthCare.gov and then back again.

“It is common sense to make it as simple and easy as possible for consumers to shop for and access health coverage,” CMS Administrator Seema Verma, MPH, said in a statement. “It is time to get the federal government out of the way and give patients the best tools to make their own healthcare decisions. We look forward to continuing to work with private partners to make sure these streamlined enrollment pathways are available, secure, and ensure a high degree of program integrity.”

The CMS guidance explained the new “proxy” direct enrollment pathway will still require the third-party to check if the customer has an existing Healthcare.gov application. Beyond that, the enrollment process can be completed on the third-party site, including determining eligibility for tax credits and picking a plan.

Offering more ways to sign up for exchange coverage could increase total enrollment, Kaiser Family Foundation Senior Vice President Larry Levitt told Axios. It could also mean consumers don’t see all of plans available to them if they go through a single insurer.

Another concern is whether third-party entities will adequately protect personal and financial information from consumers, an issue even the CMS guidance mentioned.

“CMS may release future guidance on privacy and security requirements for (direct enrollment) entities using the proxy method for enrollments to ensure that this pathway is in compliance with federal privacy and security standards,” the agency said.

The direct enrollment will only be available to customers in states with federally-facilitated exchanges or partnership exchanges which rely on Healthcare.gov, and only for “simple cases,” not complex or special enrollment customers.

Third-party entities wishing to take advantage of the new process will be able to notify CMS of their plans once additional guidance is released in June.  

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John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

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