eHealth, which operates a leading online health insurance site, ehealthinsurance.com, has proposed that it temporarily take over the enrollment process for HealthCare.gov while government contractors try to fix the federally run insurance exchange, which has had multiple problems in signing people up for health insurance.
Gary Lauer, CEO of eHealth, announced the proposal in a press conference on Wednesday, just after Health and Human Services Secretary Kathleen Sebelius went on the hot seatdefending HealthCare.gov before a congressional committee. Sebelius took responsibility for the website's deficiencies, which included an outage on Tuesday night, the second in the past few days.
In a letter to President Obama,Lauer wrote, "We are ready to help you get this program back on track promptly, with the cooperation of the federal exchange, if you allow us to take over the shopping and enrollment process in all 36 federal exchange states --without cost to the taxpayer. While your staff is working hard to repair healthcare.gov, with your support, we can be the stopgap that is needed."
The letter also noted that last summer, the Centers for Medicare and Medicaid Services (CMS) signed an agreement with eHealth allowing it to assist the federally run exchange with the enrollment process. CMS also made similar agreements with at least four other Web brokers, although Lauer didn't mention that, and a CMS spokesperson told InformationWeek Healthcarelast week that it's in the process of signing up more brokers.
Under the agreements that CMS made with the Web brokers, they were allowed to begin the enrollment of subsidy-eligible individuals for qualified health plans in the 36 states on Oct. 1. They were supposed to send their enrollment information to the CMS data hub, which determines the eligibility of applicants for government subsidies. After receiving a response, the broker would finish the enrollment and send it to HealthCare.gov, which would forward it to the appropriate health plan.
Of course, none of this has happened yet, because the online brokers can't yet connect with the CMS hub on a production basis. Last week at an earnings conference, Lauer said he expected the necessary testing to be completed within a few weeks. But at the press conference on Wednesday, he qualified his remarks, noting, "The data we've been given and the environments we've tried to test this in just aren't very good. And we won't put something up unless it works and works well. So we're not there yet. We hope to be there in the next few weeks."
What Lauer proposed to the President would hot-wire this process. Instead of having to go through HealthCare.gov, ehealthinsurance.com would go straight to the data hub, confirm eligibility, and complete enrollment. Then it would forward the enrollment files directly to the health plans, with which it already has good data connections. This would, incidentally, bypass the issues that HealthCare.gov has had in sending enrollment datato the plans.
Although Lauer said he's a strong ObamaCare supporter, it's clear that the acceptance of his proposal would be an enormous coup for eHealth. For one thing, the company would stand to make very sizable commissions from insurance companies, even if it were the federally run exchange's sole agent for just a month or two. In addition, it would give the company a big leg up on the other online brokers that are competing for consumer business in the insurance exchange. That wouldn't make those companies, such as GetInsured and GoHealthInsurance, very happy.
Although the White House has not issued an official response to the letter, CNBC quoted a spokesperson for the Department of Health and Human Services as saying that HHS isn't likely to accept eHealth's proposal because HealthCare.gov is getting better every day. HHS has promised to fix the website by the end of November.
. We've got a management crisis right now, and we've also got an engagement crisis. Could the two be linked? Tune in for the next installment of IT Life Radio, Wednesday May 20th at 3PM ET to find out.