According to CNN: “Julie Bataille of the Centers for Medicare and Medicaid Services, the agency that oversees the government’s online insurance exchange, told reporters on a conference call that as of Tuesday morning, the process called ‘direct enrollment’ should be functioning.”
What direct enrollment means is that consumers can bypass healthcare.gov. Instead, policies can now be purchased directly from insurance companies or private healthcare exchanges like eHealth.com.
For those shopping for insurance, there are several important considerations to keep in mind about this change.
Table of Contents:
The big hurdle to buying directly from insurance companies or private exchanges was the subsidy. These entities didn’t have a way to determine an individual’s eligibility for tax credits. As a result, the only way a consumer who qualified could obtain subsidies was to purchase through Healthcare.gov or state run exchanges. (Remember, 36 states don’t have their own exchange and are therefore covered by Healthcare.gov. The other 14 states and the District of Columbia have created their own exchanges. You can use this handy clickable Obamacare Map to find your state’s exchange.)
With the problems plaguing Healthcare.gov, however, the government has enabled consumers who qualify for subsidies to obtain them even if they don’t apply for insurance through the federal website. Basically, private exchanges will be able to interact with Healthcare.gov to calculate a consumer’s eligibility for subsidies.
Federal Exchanges Only
It’s important to understand that these changes only apply to those in the 36 states covered by Healthcare.gov. State run exchanges operate independently. While a consumer in one of the 14 states with their own exchanges can typically buy insurance through a private exchange (there are some exceptions), they may not be able to obtain a subsidy. For those that do not qualify for a subsidy, this isn’t a problem. But if you think you might qualify, it’s best for now to purchase through the state run exchanges (my contacts in the industry tell me this may soon be changing, too).
While there are a number of private exchanges, the one I’m most familiar with is eHealthInsurance.com. I’ve used the site to determine what insurance would cost if I were to buy an individual policy (I’m covered at work for now, so this was more out of curiosity).
What’s noteworthy was just how easy it was to compare plans and costs. With Healthcare.gov, this still cannot be done. While you can get an estimate of cost quickly from Healthcare.gov, it’s usually off by a significant amount. Without diving too deep into the details, Healthcare.gov gives estimates without first asking for your age or whether you smoke, both factors that determine premiums. In my case, the Healthcare.gov estimate was understated by almost $500 a month.
With eHealth insurance, you can compare plans and pricing by entering just a few details:
Once you input this data, you can then filter insurance plans by a number of criteria. In my case, I entered data for my wife and I and our two children. I then filtered the options for just Platinum plans so that I could compare the cost with my current insurance. Here were the results:
Interestingly, the costs under Obamacare were significantly higher than what I pay now (and I pay 100% of the premium; my employer doesn’t contribute to the cost).
Finally, it’s a good thing that the government is now allowing consumers who may qualify for a subsidy to buy outside of Healthcare.gov. According to CMS Deputy Chief Information Officer Henry Chao, the federal website is only 70% complete.