Senior Policy Analyst
The Department of Health and Human Services (HHS) has proposed new rules that would expand “direct enrollment,” in which consumers enroll in marketplace coverage by using the websites of insurers and brokers instead of the federal HealthCare.gov site. The rule encourages navigators and others certified to provide impartial consumer help to enroll consumers through these private websites. Our new paper explains why direct enrollment could lead many consumers to buy substandard coverage or miss out on benefits for which they’re eligible:
Not all direct enrollment entities have all these problems, but the program lacks safeguards to protect consumers. And despite evidence that direct enrollment already poses risks to consumers, HHS’s recently proposed 2020 payment rule — an annual update to ACA marketplace standards — would expand direct enrollment further by allowing impartial application assisters to use it to enroll consumers.
These changes are consistent with the Administration’s larger effort to privatize more marketplace functions and reduce the resources, public presence, and capacity of the marketplaces themselves. That will hurt consumers by steering more of them toward plans that provide substandard coverage and away from ACA-compliant plans or no-cost public coverage.