Laying bare your finances to apply for health care, but more simply

Wednesday, May 1, 2013

photo This application is the short form for the new federal Affordable Care Act. The first draft was as mind-numbing as a tax form. Tuesday the Obama administration unveiled simplified application forms for health insurance benefits under the federal health care overhaul. The biggest change: a five-page short form that single people can fill out. That total includes a cover page with instructions, and an extra page to fill out if you want to designate someone to help you through the process.

WASHINGTON - After a storm of complaints, the Obama administration on Tuesday unveiled simplified forms to apply for insurance under the president's new health care law. You won't have to lay bare your medical history but you will have to detail your finances.

An earlier version of the forms had provoked widespread griping that they were as bad as tax forms and might overwhelm uninsured people, causing them to give up in frustration.

The biggest change: a five-page short form that single people can fill out. That form includes a cover page with instructions and another page if you want to designate someone to help you through the process.

But the abridged application form for families starts at 12 pages, and grows as you add children. Most people are expected to take another option, applying online.

The ease or difficulty of applying for benefits takes on added importance because Americans remain confused about what the health care law will mean for them. A Kaiser Family Foundation poll released Tuesday found that 4 in 10 are unaware it's the law of the land. Some think it's been repealed by Congress. In fact, it's still on track.

And it's a mandate, not a suggestion. The law says virtually all Americans must carry health insurance starting next year, although most will just keep the coverage they now have through their jobs, Medicare or Medicaid.

At his news conference Tuesday, President Barack Obama hailed the simplified forms as an example of how his team listened to criticism from consumer groups and made a fix. The law's full benefits will be available to all next year, he emphasized, even if Republicans in Congress still insist on repeal and many GOP governors won't help put it into place.

When the first draft of the application turned out to be a clunker, "immediately, everybody sat around the table and said, 'Well, this is too long, especially ... in this age of the Internet,"' Obama recounted. "'People aren't going to have the patience to sit there for hours on end. Let's streamline this thing."'

The flap over the application forms was a "first test" of the administration's ability to confront problems as they emerge, said Sam Karp, vice president of programs at the California HealthCare Foundation.

"Being nimble enough to identify, then fix, problems will be critical to successfully enroll millions of Americans who will become newly eligible for coverage," he said.

The applications will start becoming familiar to consumers less than six months from now, on Oct. 1, when new insurance markets open for enrollment in every state. Most people already signed up in their employer's plan don't need to bother with the forms.

Filling out the application is just the first part of the process, which lets you know if you qualify for financial help. The government asks to see what you're making because Obama's Affordable Care Act is means-tested, with lower-income people getting the most generous help to pay premiums. Consumers who aren't applying for financial help still have to fill out a five-page form.

Once you're finished with the money part, actually picking a health plan will require additional steps, plus a basic understanding of insurance jargon.

Benefits begin Jan. 1, and nearly 30 million uninsured Americans are eventually expected to get coverage.

While the first drafts of the applications were widely panned, the new forms were seen as an improvement. Still, consumers must provide a snapshot of their finances. That potentially includes multiple sources of income, from alimony to tips to regular paychecks.

On the list: unemployment, pensions, Social Security, other retirement checks and farming and fishing income. Individuals will have to gather tax returns, pay stubs and other financial records before filling out the application.

"Given the amount of information necessary to determine eligibility, it's hard to see how the forms could be any shorter," said Robert Laszewski, a former insurance executive turned industry consultant.

Although the new forms are more concise, the administration wasn't able to get rid of complexity. One question asks family applicants with at least one member covered through a job for "the lowest-cost plan that meets the minimum value standard offered only to the employee." Huh?

Administration officials expect most people to apply online. The process will route consumers to either private plans or Medicaid. Identification, citizenship and immigration status, as well as income details, are supposed to be verified in close to real time through a federal "data hub" pinging Social Security, the Homeland Security department and the Internal Revenue Service.

Under Obama's overhaul, insurers will no longer be able to turn away the sick or charge them more. The pitfalls of giving the wrong answer to a health care question will be gone, but consumers who underestimate their incomes could be in for an unwelcome surprise later on in the form of smaller tax refunds.

One section eliminated in the new form asked applicants if they also wanted to register to vote. Some congressional Republicans had criticized that, calling it politically motivated.