White House Weighs Key Concession to Health Insurers - Wall Street Journal

Updated Nov. 18, 2013 5:16 p.m. ET

The Obama administration said Monday it is weighing whether to grant a key concession on the health-care law to big insurers under which they could directly sign up for coverage millions of Americans who qualify for tax credits.

If completed, the plan could help some people bypass troubled health-insurance websites including HealthCare.gov.

People can now go straight to an insurer to buy coverage that meets the same standards as policies sold on health-insurance exchanges such as HealthCare.gov. But if customers are eligible for subsidies toward the cost of their premiums, they can get those subsidies only by purchasing their coverage on the exchanges, where plans can be compared side by side.

White House spokesman Jay Carney told reporters Monday that the administration is "working to set up direct enrollment through insurance companies so that Americans could choose to enroll directly through the insurance company."

White House officials said after the briefing that Mr. Carney had been referring only to the existing direct-enrollment process, not about expanding it to the millions of Americans who are expected to qualify for subsidies toward the cost of their coverage next year.

The decision about expanding direct enrollment has been closely watched as the administration reckons with the problems of HealthCare.gov, which is serving 36 states that declined to run their own exchanges. The administration has set a goal of the site working for most users by Nov. 30, but that leaves just about two weeks for people to sign up for coverage that can take effect Jan. 1.

Mr. Carney said the administration was still focused on getting the website going but was also willing to make changes to its approach to try to get as many people signed up as possible.

"It's the end here that matters, not necessarily the means," he said. "We have to make sure that there are other means available for the American people, even as we make improvements to the website."

Supporters of the law had worried that direct enrollment could undermine a tenet of the exchanges: that people can compare options from competing insurers. Newer insurers would likely lose out in such a scenario because they don't have the same marketing firepower as the dominant carriers.

The administration is still wrestling with technical obstacles with the existing direct enrollment system. To expand it to people who qualify for subsidies, the federal government must find a way to guarantee to insurers that calculations they make about enrollees' eligibility for tax credits will be accurate and binding.

Write to Louise Radnofsky at louise.radnofsky@wsj.com, Jared A. Favole at jared.favole@wsj.com and Colleen McCain Nelson at colleen.nelson@wsj.com