NACDS weighs in on upcoming ACA enrollment process

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WASHINGTON — With the next open enrollment period for health insurance under the Affordable Care Act set to begin on November 15, National Association of Chain Drug Stores members discussed pharmacy issues this month with Health and Human Services Secretary Sylvia Burwell.

“Patients rely on their pharmacies as trusted sources of information on health care topics, so NACDS again will make it a priority to work on a collaborative basis to help present clear and accurate information to patients — to empower their health care decisions in the still new health exchange landscape,” NACDS president and chief executive officer Steve Anderson said afterward.

He said NACDS has appreciated the opportunity to make recommendations intended to create a smooth start for new exchange enrollees seeking prescription drug coverage.
NACDS members also valued the chance to continue to discuss “opportunities to leverage the value of pharmacy in other areas,” Anderson said. “These include familiar and important functions like the dispensing of medication and helping patients take their medications correctly, as well as opportunities to make new and better use of the extensive education of pharmacists for the good of patient care.”

The Obama administration is advising consumers that they should return to the federal health insurance marketplace to renew coverage for next year.

In addition, consumers are being urged to update information on their income and family size and to compare their current insurance with alternatives, which could offer better coverage at a lower cost.

Kevin Counihan, who heads the federal marketplace, said the notices were being sent to about 7.3 million people enrolled in health plans purchased through the exchange, HealthCare.gov, which serves three dozen states.

Federal officials also announced that consumers shopping for insurance on HealthCare.gov will use an application that is roughly one-fourth as long as the complex questionnaire rolled out in 2013. The new questionnaire is 16 pages — last year’s involved 76 pages.

The change will go into effect next month after completion of extensive testing of the application, which has been under way since July by federal officials and contractors.

As many as 5 million people are expected to return to the site and make changes to the coverage plans in which they enrolled last year, with millions more projected to sign up for new plans through the site. With the new system in place, 70% of people who have never bought coverage on HealthCare.gov are likely to go through an identity-verification portal and complete the new 16-page application.

A version of this new, shorter application was previewed to the media. It still requires consumers’ addresses, current income and related details, but no longer spreads the questions across multiple pages.

Meanwhile, the Employers for Flexibility in Health Care (E-FLEX) Coalition has raised questions and key concerns about the challenges that employers face in implementing the ACA. In a letter to federal officials, the coalition expressed concerns from employers of all sizes across the country and emphasized solutions for minimizing the number of employees who must repay advanced premium tax credits each year, as a way to ease the significant compliance burden on ­employers.

“Retailers have worked tirelessly with the administration on solutions to address the challenges this law presents for employers,” said Christine Pollack, vice president of government affairs at the Retail Industry Leaders Association. “With less than three months before the employer mandate goes into effect, significant issues and pertinent questions remain.

“Employers are working to comply with the law, and it is important that the administration does all it can to mitigate the upcoming challenges for businesses, employees, exchanges and the IRS.”

The coalition, composed of leading trade associations and employers in the service-related industries, focused on four areas of concern in its letter: information-reporting requirements, determination of employee eligibility for premium tax credits, the employer notification process when exchanges have determined which employees are eligible for premium tax credits, and administration of advanced premium tax credits for 2015.

The second round of open enrollment runs for three months, half the length of the first enrollment period.

During the first open season, 8 million people signed up for insurance. About 7.3 million have paid their premiums and are still enrolled, surpassing the goal that was set by President Obama.

Burwell has declined to set a numerical goal for enrollment in the second enrollment period. The Congressional Budget Office estimates that enrollment will climb to a total of 13 million.


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