Yesterday afternoon, the Center for Medicare and Medicaid Services (CMS) held a conference call with navigators, assistors and brokers on how to deal with the mass of people who have a loss of employer sponsored insurance Special Enrollment Period (SEP). CMS is not running a no strings attached Open Enrollment Period (OEP), as many insurers and advocates had wanted for Healthcare.gov, but they are applying a lot of lube to the administrative pathway to speed the standard SEP process along. The critical information is about 30:45 in:
“I do want to point out that right now the Marketplace is not requiring consumers to upload supporting documentation to verify their eligibility to enroll in a Special Enrollment Period. So instead, consumers may attest to that information that they provide on the application while they are applying for a SEP.” (MY EMPHASIS)
This is very similar to the announcement from the Idaho state-based marketplace last week. Attestation is sufficient with no documents that need to be uploaded after an individual requests them from an office unlikely to be staffed.
We are getting a massive lesson in administrative burden and administrative friction in the delivery of public benefits. Public benefits can be readily and easily available. Public benefits can be legally available and “accessible” after jumping through a lot of hoops. If a public benefit is easy to access, then lots of people will use the public benefit. If a public benefit is difficult to access, not many people will use that benefit. And the people who get a hard to receive benefit tend to be systemically different than folks who are blocked from access by paperwork barriers.
This applies to food stamps.
This applies to voting.
This applies to Medicaid.
This applies to college financial aid.
And it applies to to ACA special enrollment periods as well.
Healthcare.gov’s Idaho’s removal of a documentation requirement and replacing it with an attestation dramatically reduces the administrative burden for people who have lost insurance. This is a good step to increase enrollment and provide some financial protection for folks who have gotten hit hard right now.