Between October and March, HHS hopes to enroll 7 million people in the health plans that will compete for business in the state insurance exchanges. By 2022, the number of enrollees is expected to swell to 24 million, according to the Congressional Budget Office.
If the insurance exchanges meet the projection for this year, noted Kaiser Health News, it would be the biggest open enrollment season in the history of health insurance. But to get there, HHS and its partners will have to overcome widespread ignorance among the uninsured about the state insurance exchanges.
To help address these challenges, HHS has transformed Healthcare.gov into an educational site that provides general information about the insurance exchanges and the Affordable Care Act. Starting October 1, eligible individuals and firms with up to 100 employees will be able to purchase insurance, in whatever state they live or do business, through Healthcare.gov.
[ Healthcare reform is increasing expectations for state IT chiefs. See State CIOs Make Progress On Health IT. ]
According to a news release, "Key features of the website, based on consumer research and online commercial best practices, include integration of social media, sharable content and engagement destinations for consumers to get more information. The site will also launch with Web chat functionality to support additional consumer inquiries."
The website is designed so that consumers can access it from mobile devices as well as desktops and laptops. In addition, HHS is providing an application programming interface (API) so that developers can insert some of the site's contents in their own applications.
Meanwhile, an equally big health IT story is playing out behind the scenes. The Centers for Medicare and Medicaid Services (CMS) -- a unit of HHS -- and some states are scrambling to assemble the health IT infrastructure that will be needed when the exchanges open for business on October 1. In 34 states, the feds are building the exchanges because the states either declined to participate or agreed to help CMS carry out only some of the exchange operations. Among these functions, a new GAO report says, are eligibility and enrollment, plan management, and consumer assistance.
At the center of this huge enterprise will be a CMS data hub. "To support consumer-eligibility determinations, for example, CMS is developing a data hub that will provide electronic, near real-time access to federal data, as well as provide access to state and third-party data sources needed to verify consumer-eligibility information," GAO noted. "While CMS has met project schedules, several critical tasks, such as final testing with federal and state partners, remain to be completed."
The report further describes the work that has been done on this data hub, including external testing of the link between CMS and the Internal Revenue Service. Information from the IRS and other sources will determine whether people buying insurance on the state exchanges are eligible for federal subsidies.
Explaining how this will work, GAO says, "CMS has also begun to test capabilities to establish connection and exchange data with other federal agencies and the state agencies that provide information needed to determine applicants' eligibility to enroll in a QHP [qualified health plan] or for income-based financial subsidies, such as advance premium tax credits and cost-sharing assistance, Medicaid or CHIP."