It’s easier to apply for green card than Obamacare
Application for new health exchanges includes 61 pages of instructions
April 4, 2013, 12:15 p.m. EDT
By Jen Wieczner
If you thought nothing could be more tedious than filling out your tax forms, just wait until you try to apply for health insurance through the Affordable Care Act’s new exchanges.
The draft of the paper application is 15 to 21 pages, depending on whether someone is applying individually or for their family. See the Application for Health Insurance
And the instructions for the application run no less than 61 pages. That’s nearly six times longer than the instructions for a green-card application. (There are also videos of the process.)
“If you like IRS forms, you’re going to love this one,” says Ken Hoagland, chairman of Restore America’s Voice, a conservative organization that advocates for the repeal of the health-care law. “These are the kinds of things that are going to drive people crazy.”
Adding to the confusion from this new bureaucracy is that experts say most Americans are still largely in the dark about what the health-insurance exchanges — the new marketplaces for individual insurance stipulated by the health-reform law — even are. Though government officials are hurrying to set them up before open enrollment for 2014 begins this fall, a survey released today by InsuranceQuotes.com found that 90% of U.S. consumers don’t know that the exchanges open Oct. 1, and 22% said they thought the exchanges were already open now.
That lack of knowledge doesn’t bode well for how consumers will actually manage to sign up for insurance on their own, experts say — something they will have to do or else pay a penalty mandated by the health-reform law.
The Department of Health and Human Services recently released the draft versions of the applications consumers will need to fill out in order to get insurance if they can’t get it through their employer or family. But while the point behind the law and the exchanges is to make it easier for Americans to get health insurance, some consumers are complaining that a major barrier now stands in their way: too much paperwork.
“It’s a lot of information that consumers are going to have to provide, and that could deter people from signing up,” says Laura Adams, senior insurance analyst at InsuranceQuotes.com, part of Bankrate.com, which tracks interest rates. “That could be an issue for some people who don’t like paperwork. And who likes paperwork?”
The forms bring to mind the IRS instructions for filing the 1040 tax form, which is 105 pages long. In fact, many of the questions have less to do with health matters than financial ones.
A little-known government disclosure requirement offers a clue, at least, to how much time it will take consumers to fill out the forms. To comply with the Paperwork Reduction Act, the Health Department had to submit an “Information Collection Request” along with the draft forms, detailing why it is seeking the information and an estimate for how long it will take the public to provide. The online application will take 15 to 30 minutes to complete depending on whether consumers are applying for additional government subsidies, according to the ICR.
Meanwhile, the paper application will take 20 to 45 minutes to finish. (By comparison, the department estimated that applications through the small-business health-plan exchanges, known as SHOP, will only take about 10 to 13 minutes to complete.)
But experts say those time estimates don’t include the many hours of homework consumers will have to do before they will even be equipped to fill out the forms, like gather proof of their income. “Consumers are going to need to be prepared,” Adams says.
Government officials and all kinds of other organizations are now parsing the exchange applications and sending feedback to the Health Department on how to make the forms clearer if not idiot-proof. The Massachusetts Medicaid office, for example, suggested in a letter in February that the phrase “please print” be added to the paper form, “so the written information will be as legible as possible.”
And members of the House Ways and Means committee complained that the forms included too many gratuitous questions, asking about applicants’ voter registration status. “As if the insurance application process will not be complicated enough, HHS’s proposed application includes an inquiry about something totally unrelated to health insurance,” wrote Louisiana Republican Rep. Charles Boustany in a letter last week to the Department.
While the health reform law also provides for a support staff known as “Navigators” to help consumers sign up for insurance in the exchanges, experts worry that the Navigators will be overwhelmed with requests, and consumers who call their inundated phone lines will be stuck on hold for a while. “People won’t be able to get through,” Adams says. (Yesterday, HHS proposed training and ethics regulations for the Navigators, which don’t include specific provisions about answering phones in a timely fashion, but dictate that Navigators “will be fair and impartial and will be appropriately trained, and that they will provide services and information in a manner that is accessible.”)
Adams recommends that consumers start the application process right away when the exchanges open in October, because as 2014 approaches, the deadline for when all Americans must have health insurance, the rush of last-minute applicants may bring the enrollment websites crashing down. “Our fear is that people are going to put it off til New Year’s Eve, and by then the sites will be overloaded and Navigators will be overloaded,” Adams says.