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A Small Paper Problem: The Health Exchanges Face An Avalanche of Paper Applications

When HealthCare.gov and some state-run insurance marketplaces ran into trouble with their websites in October and November, they urged consumers to submit paper applications for coverage.

Now, it’s time to process all that paper. And with the deadline to enroll in health plans less than two weeks away, there’s growing concern that some of these applications won’t be processed in time.

The Associated Press reported last week that federal officials are now advising navigators—groups paid to assist consumers with enrollment—not to use paper applications anymore, if they can help it.

“We received guidance from the feds recommending that folks apply online as opposed to paper,” said Mike Claffey, spokesman for the Illinois Department of Insurance.

After a conference call earlier this week with federal health officials, Illinois health officials sent a memo Thursday to their roughly 1,600 navigators saying there is no way to complete marketplace enrollment through a paper application. The memo, which Claffey said was based on guidance from federal officials, said paper applications should be used only if other means aren’t available.

Federal health officials also discussed the issue during a conference call Wednesday with navigators and certified counselors in several states.

“They’ve said do not use paper applications because they won’t be able to process them anywhere near in time,” said John Foley, attorney and certified counselor for Legal Aid Society of Palm Beach County, who was on the call.

According to an enrollment report released Wednesday by the U.S. Department of Health and Human Services, about 83 percent of the 1.8 million applications completed between Oct. 1-Nov. 30 were filled out online; the rest were on paper. The online figure was higher, 91 percent, in the 14 states running their own health exchanges, compared to 80 percent for Healthcare.gov, which processes enrollments for the other 36 states.  But even outside the federal exchange, paper is proving to be a problem.

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