WASHINGTON — Applying for benefits under President Barack Obama's health care overhaul could be as daunting as doing your taxes.
The government's draft application runs 15 pages for a three-person family. An outline of the online version has 21 steps, some with additional questions.
Seven months before the Oct. 1 start of enrollment season for millions of uninsured Americans, the idea that getting health insurance could be as easy as shopping online at Amazon or Travelocity is looking like wishful thinking.
At least three major federal agencies, including the Internal Revenue Service, will scrutinize your application. Checking your identity, income and citizenship is supposed to happen in real time, if you apply online.
That's 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.
Once you're finished with the money part, picking a health plan will require additional steps.
And it's a mandate, not a suggestion. The law says virtually all Americans must carry health insurance starting next year, although most will keep the coverage they now have through their jobs, Medicare or Medicaid.
Some are concerned that a lot of uninsured people will be overwhelmed and give up.
“This lengthy draft application will take a considerable amount of time to fill out and will be difficult for many people to be able to complete,” said Ron Pollack, executive director of Families USA, an advocacy group supporting the health care law. “It does not get you to the selection of a plan. When you combine those two processes, it is enormously time-consuming and complex.”
Pollack is calling for the government to simplify the form and for an army of counselors to help uninsured people navigate the new system.
Drafts of the paper application and a 60-page description of the online version were posted online by the Health and Human Services Department, seeking feedback from industry and consumer groups. Those materials, and a recent HHS presentation to insurers, run counter to the vision of simplicity promoted by administration officials.
“We are not just signing up for a dating service here,” said Sam Karp, a vice president of the California HealthCare Foundation, who nonetheless gives the administration high marks for distilling it into a workable form. Karp was part of an independent group that designed a model application.
The government estimates its online application will take a half-hour to complete, on average. If you need a break, or have to gather supporting documents, you can save your work and come back later. The paper application is estimated to take an average of 45 minutes.
The new coverage starts Jan. 1. Uninsured people will apply through new state-based markets, also called exchanges.
Middle-class people will be eligible for tax credits to help pay for private insurance plans, while low-income people will be steered to safety-net programs such as Medicaid.
Because of opposition to the health care law in some states, the federal government will run the insurance markets in about half the states. States, such as Oklahoma, that reject the law's Medicaid expansion will have large numbers of poor people uninsured.
Here are some views on the system:
Pro: If you apply online, you're supposed to be able to get near-immediate verification of your identity, income and citizenship or immigration status. An online government clearinghouse will ping Social Security for birth records, IRS for income data and Homeland Security for immigration status. “That is a brand new thing in the world,” Karp said.
Con: If your household income has changed in the past year or so and you want help paying premiums, be prepared to do extra work. You're applying for help based on your expected income in 2014. But the latest tax return the IRS would have is for 2012.
Pro: You won't have to fill out a medical questionnaire, although you do have to answer whether you have a disability. Even if you are disabled, you can get coverage for the same premium a healthy person of your age would pay.
Health and Human Services estimates it will receive more than 4.3 million applications for financial assistance in 2014. Because families can apply together, the government estimates 16 million people will be served.
HHS spokeswoman Erin Shields Britt said the application is a work in progress, “being refined thanks to public input.”
It will “help people make apples-to-apples comparisons of costs and coverage between health insurance plans and learn whether they can get a break in costs,” she added.