Why new ACA subsidies will roll out slowly
The new stimulus bill made tens of millions of Americans eligible for new health insurance subsidies. But many will have to wait to get help: It will probably take a year for the full emergency aid to reach people because of website complications and other logistical problems.
President Joe Biden has promoted the subsidies as fulfilling his campaign promise to shore up the Affordable Care Act. And for many uninsured Americans, the new program will offer free or inexpensive health plans that were previously unaffordable.
But the health law’s complex structure makes it hard to retool insurance subsidies, let alone create a new program for the unemployed. The systems that distribute the benefits depend on government coders who update websites, and marketers who help people understand the new programs and jump through various administrative hoops to collect them.
“I don’t think there is enough Xanax out there for this,” said Jodi Ray, project director at Florida Covering Kids and Families, which manages the state’s health law outreach efforts.
Memories of Healthcare.gov’s notoriously bumpy 2013 rollout still linger in the minds of those overseeing the new update. The debacle quickly became a punchline for late-night television hosts and a political liability for an already divisive law.
Now, it’s a cautionary tale of a federal government website unprepared for a deluge of shoppers.
“Technology is not selfexecuting — it takes work,” said Joel Ario, a managing director at the health consulting firm Manatt and a former official in the Obama administration before Healthcare.gov’s launch. “That’s unfortunate when you’re trying to deal with a large program like this.”
The first step of the federal upgrade should be ready by April 1: Healthcare.gov, where people sign up for insurance in 36 states, will start showing prices that reflect the new policy. For more than 5 million Americans with lower incomes, health plans will be available for no monthly premium. For others who earn more, new discounts could be worth hundreds of dollars a month.
But getting those lower prices will require work: Americans who already have “Obamacare” insurance will have to go back to the website where they bought their insurance; make sure they don’t want to switch plans; and certify that they want the new, expanded tax credits. Those who fail to do this will keep paying their current price. They should eventually receive the additional funds as a large refund with their 2021 taxes next spring.
People who have bought their own insurance elsewhere will need to cancel their current plan and switch to an eligible one.
“The main thing we’ve been telling people is: Go back onto Healthcare.gov, work with your navigator, and get your application updated,” said Adam Vanspankeren, program director with Covering Wisconsin.
Another key part of the stimulus provides free health plans with a generous set of benefits to Americans who received unemployment insurance this year. Even though the coverage will be retroactive to Jan. 1, the new benefit will take months to set up, and won’t appear on Healthcare.gov until this summer. That timeline may require people to visit Healthcare.gov as many as three times: once to sign up for a plan, then to get the new income-based subsidies, and again to get the special unemployment benefit once it’s ready.
“We’re going to miss a lot of consumers by making them circle back,” said Ray, the project director in Florida. “We don’t have enough resources, and we don’t have a lot of time.”
The slow rollout of government aid is partly the result of the technological challenge of updating Healthcare.gov, which is connected to a maze of federal systems to verify people’s residency, income and insurance choices.