Some major health insurers are so worried about the Obama administration's ability to fix its troubled health care website that they are pushing the government to create a shortcut that would allow them to enroll people entitled to subsidies directly rather than through the federal system.
The idea is only one of several being discussed in a frantic effort to find a way around the technological problems that teams of experts are urgently trying to resolve.
So far, the administration has resisted the idea, partly because of concerns about giving insurance companies access to personal data.
People familiar with the matter said no such modifications are planned; even some insurers are not holding out much hope.
But senior White House officials said the administration was open to ways in which insurers could handle more enrollments and had stepped up efforts to make that possible because of the technical problems with the website.
“It was something we were always doing,” one official said, but it is “of additional value now.”
Chris Jennings, a senior health care adviser to President Barack Obama, said the administration was “continuing to pursue additional avenues by which people can enroll, such as direct enrollment through insurance companies, that will help meet pent-up demand.”
In proposing the idea, the insurers said a bypass giving them direct access to the federal platform that determines a consumer's eligibility for a subsidy would alleviate the traffic on the website, HealthCare.gov, and provide more breathing room to fix complicated technical problems that threaten to persist beyond a Dec. 1 deadline.
But even if such a shortcut could be designed, federal officials are concerned about protecting personal data, such as confidential financial and tax information and immigration status. The security and privacy issues are likely to overshadow any possible compromise, according to people briefed on the discussions.
A more likely solution is for consumers to be able to work directly with an insurer to estimate their qualifications for a subsidy, leaving federal verification to a later date, some insurers said. Insurance executives declined to speak on the record because of company policies and concerns about alienating political officials.
Time is running out. Kathleen Sebelius, the secretary of health and human services, has promised to have the website's technical problems largely solved by the end of the month. But inside the White House, there is increasing anxiety that the troubled rollout of the health care site could imperil the remainder of Obama's presidency.
Aside from the direct enrollment option, insurers and federal officials are examining other ways in the coming weeks to sign up the millions of Americans looking for health insurance.
However, none of the options represents a quick fix. One idea being considered would allow people to enroll before the paperwork is completed. At the extreme, despite strong resistance from the insurance industry, there is even talk of extending the deadline for obtaining insurance on the marketplaces by months.
Consumers must now enroll by Dec. 15 for insurance coverage that would begin Jan. 1. The open enrollment period is to end March 31. The main stumbling block for consumers is the need to determine their eligibility for subsidies and the amount. Insurance companies now can only estimate the amount for them. It is up to the government to verify eligibility.
“The question is, can they create a separate direct pathway so consumers can get that information on their subsidies?” asked one industry official. “If they don't have HealthCare.gov up and running by the end of the month, direct enrollment is critical.”
The other option, allowing consumers to obtain their own estimates, seems more palatable. It is unclear whether that proposal is possible. Insurers are worried that they will have offered coverage to individuals whose actual subsidies are less than they have estimated, potentially leaving the insurers or the people themselves financially exposed.
“I think there are potential work-arounds,” said an executive of a major insurer. “I think we have some leeway here so long as people are not in a situation where individuals have to pay significantly more than expected or plans end up in a position with cash-flow issues.”
Insurers are opposed to the idea of extending the enrollment period. They say it encourages people to wait to sign up, particularly the young and the healthy, an age group that insurers need to balance the cost of insuring people with expensive health conditions. They are also worried about the effect of the delay on their ability to price plans for 2015.