CMS outlines plans for year three on federal health exchange

New consumer tools are in the works for Healthcare.gov, as the federal government focuses on the exchange’s long-term success.

The FFM off to a good start, said Andy Slavitt, acting administrator for the Centers for Medicare and Medicaid Services, Thursday at a Washington conference sponsored by Enroll America. But, “our job is just getting started,” he said. “Real changes need to take place to” build on Healthcare.gov’s momentum.

The marketplace should bring consumers “record choice and access to affordable coverage,” Slavitt said. But those choices also need to focus on price. He said the government wants all insurers to have single-digit increases on the vast majority of plans for year three open enrollment.

Despite that, individuals who buy health insurance through Healthcare.gov could see big increases in their premiums next year. Requests are varied — Blue Cross Blue Shield of New Mexico is proposing hikes between 49% and 65% — but several insurers are seeking double-digit increases, according to a list of proposed rate increases of 10% or more that the Centers for Medicare and Medicaid Services posted June 1 on Healthcare.gov.

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The posted rate increases — which reflect the cost before subsidies — are subject to a review process that “allows for officials, experts and the public to examine and question why a particular health insurance plan’s yearly increase in its premium is high (10% or greater) before it is finalized,” according to CMS.

 Any plan with an increase of more than 10% will be “not only subject to review, but [also] public scrutiny,” Slavitt said at the conference.

Among other changes that are planned for this fall’s enrollment, which begins November 1, are new tools for consumers that will be introduced in year three and improved upon in year four. Slavitt would not provide specifics, since he said CMS has overpromised in the past, but did promise a “simpler, more improved experience and more vibrant marketplace that is ripe for innovation.”

CMS remains “dead focused” on people with more complex situations, such as variable incomes, Slavitt added. “Asking someone to estimate their one-year income is in some ways is asking some of us to estimate our 10-year income,” he said. “It’s hard.”

CMS is also planning for future open enrollment and ways to get consumers coverage “when, where and how they choose in ways we don’t restrict,” Slavitt explained.

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When they are sick, people want to make sure they get a consistent experience wherever they go, he said when asked about a plan for future open enrollments. “We have an enormous opportunity to make it fundamentally right and the good news is the majority of physicians out there … want to practice good medicine,” he said. “They want to get rewarded for it. These aren’t political issues.”

“The vast majority of things in health care aren’t political. We have to enable people to thrive,” he added. “We [have] to get to making sure people have their fundamental needs met. I think we are on the path. I would not take the eye off the ball.”

Aneesh Chopra, the first chief technology officer of the United States, also spoke at the conference, saying key to many of these changes is open data. “We need to make provider directories as easy as apple pie,” he said.

Chopra, now co-founder of Hunch Analytics, said that patient data tracking must evolve. Having forms auto-fill and health information available on an open app will lead to a “better personalized experience,” he said.

The most important data set, personal health information,  does not move around easily, Chopra said. “The reality is we have technology standards to move this forward,” he added. “It’s just a political will.”