DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, MD 21244-1850 
 
Center for Medicaid, CHIP and Survey & Certification 
 
CMCS Informational Bulletin 
  
 
DATE:  July 1, 2010   
 
     
FROM:  Cindy Mann, Director 
  Center for Medicaid, CHIP and Survey & Certification (CMCS) 
 
SUBJECT:  Health Insurance Portal Launch 
 
As you know, today marks the launch of www.Healthcare.gov, a robust and exciting consumer 
focused resource on many facets of health care. This site is a government-wide initiative to 
provide consumers with a place to go to receive information on the Affordable Care Act and its 
implementation, information about their rights under various health care laws, educational 
materials describing the public and private programs in the health care system, and coverage 
options that may be available to each individual in his or her own State. 
 
As you also know, the law required that we include information about Medicaid and CHIP 
programs in the coverage options portion of this site.  This required, in fairly short order, the 
collection of eligibility and benefits information from each States Medicaid and CHIP State plan 
and/or waiver documents. Your input and assistance with validation of the data was incredibly 
valuable and we appreciated your willingness to turn around the information within a very short 
period of time. We adjusted our data to address the comments we received and will continue to 
work with States on further refinements of the data, as well as the presentation of the information 
going forward.  This website will be a constantly evolving product and we will seek your 
guidance on future changes through a Federal/State advisory group which will be formed by the 
end of this month.   
 
As you might imagine, the programming for this portal -- combining the Medicaid and CHIP 
programs with private sector programs -- was challenging to say the least.  The consumer focus 
of this portal remained paramount throughout the process, but implies all of the challenges that 
you too have faced when providing information to consumers in your States.  
 
Visitors to www.Healthcare.gov will be asked general questions about themselves including: age 
range; self-disclosure of having a disability, health condition, or need for long-term care; 
pregnancy status; whether the visitor has dependent children; and whether they have trouble 
affording insurance.  All Medicaid and CHIP output data are sorted based on those variables.  
   
   
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The portal does not collect information on income or family composition, diagnosis (specific 
disability or health condition), SSI status, or many other factors that would be necessary to more 
precisely assess eligibility for programs or services.  The portal is not intended to be a promise of 
eligibility; rather it is designed to give people enough information to make an informed decision  
about whether it is worthwhile to pursue one or more of the coverage options available in their 
State. 
 
The output that consumers receive from www.Healthcare.gov includes services that States make 
available under Medicaid to the categorically or medically needy, CHIP services, and the 
presence of potentially relevant special programs including home and community-based services 
(HCBS) waivers, and 1115 demonstrations. This information is provided based on the answers to 
the questions that consumers feed into the portal as they enter.  The information is displayed with 
a disclaimer that reinforces the message that the site does not determine eligibility. Some 
programs also trigger additional disclaimers, for example, the possibility of waiting lists if 
waiver program content is displayed.  Finally, consumers are provided with contacts to learn 
more about their coverage options including consumer information numbers and links to your 
own State websites to further research the programs.     
 
Changes to the programming and design were being made on a priority basis continuously over 
the last 10 days. We provided significant feedback to that change process, based in part on your 
comments and suggestions. Additionally, demonstrations were conducted at the end of last week 
for different groups including State, consumer and health plan representatives.  Feedback from 
those demonstrations was also incorporated into the site.   
 
However, there are several remaining change requests that will be incorporated soon after the 
launch.  We will be making some significant improvements including building in all State names 
for programs and streamlining the design of the Medicaid results page.  We look forward to 
receiving your change requests and to building State suggestions into the change process.  There 
will also be opportunities to provide feedback embedded in the website itself.  Additionally, we 
will maintain the web portal mailbox that you used for the data verification process to collect 
suggestions.  The address is:  medicaidportal@cms.hhs.gov. 
 
I hope you will find this information helpful.  I have also attached a few of the frequently asked 
Questions and Answers that might be useful as you continue to familiarize yourselves with this 
site.  If you have questions about www.Healthcare.gov or would like to volunteer to serve on the 
State workgroup to update the website, please contact Carey Appold at 
Carey.Appold@cms.hhs.gov or 410-786-2117.  Again, thank you for your partnership on this 
effort.   
   
   
Page 3  Health Insurance Portal Launch 
 
Attachment 
 
Questions and Answers: HHS Web Portal (www.healthcare.gov) 
 
 
Q:  What is HealthCare.gov? 
 
HealthCare.gov is a new website, debuting on July 1, 2010 in accordance with one of the 
requirements of the Affordable Care Act.  Its mission is to help Americans take control over their 
own health care and make the choices that are right for them  by putting the power of 
information at their fingertips.   
 
The site delivers three core benefits to consumers: 
 
  Extensive information about your rights, how to navigate the current insurance 
market, and how the Affordable Care Act will help you  tailored to your life situation 
(e.g., seniors, young adults, families with children, people with disabilities, small 
employers), and drawing from more than 500 pages of content written for 
HealthCare.gov 
 
  Ability to search for both public and private health coverage options that are right 
for you  
 
  Compiles an unprecedented catalog of federal, state, and private insurance options 
for consumers in one place  including Medicaid programs, the Childrens Health 
Insurance Program, the new Pre-Existing Condition Insurance Plan and other 
currently operating state high risk pool plans, coverage options such as the ability 
for young adults to be covered through their parents until they are 26, and 
products from more than 1,000 private insurance carriers across the nation 
 
  Based on your answers to a series of questions, produces a menu of potential 
coverage choices personalized for you  with literally billions of potential 
personal scenarios supported 
 
  Coming in October of this year:  private insurance plan price estimates and 
more detailed information on benefits and cost sharing (e.g., deductibles, co-
insurance), putting even more power in the hands of consumers 
 
  Information about new resources and benefits provided by the Affordable Care Act, 
as they become available, such as the Patients Bill of Rights and new benefits for 
seniors; you can sign up for email updates to stay informed 
 
The version of HealthCare.gov launched on July 1, 2010 is just the beginning  with the help of 
user feedback gathered throughout the site, we will be continually adding to the information on 
the site and make it ever easier to use.  As health care gets better, so will HealthCare.gov.   
 
   
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Q:  How many products are on HealthCare.gov as of July 1? 
 
HealthCare.gov has assembled an unprecedented catalog of federal, state, and private insurance 
options for consumers in one place.  This catalog includes:   
 
  Every state Medicaid program 
  Every state Childrens Health Insurance Program (CHIP) 
  The new Pre-Existing Condition Insurance Plan (PCIP) created by the Affordable Care 
Act 
  Other high risk pool programs currently operated by states 
  Special options you have in particular situations, such as COBRA, the ability to enroll in 
a spouses plan, the ability to get coverage under your parents plan until youre 26 
(newly created by the Affordable Care Act), etc. 
  Products currently available from more than 1,000 private insurance carriers across the 
nation 
  Note:  a carrier is defined as an insurer registered with a state (so Aetna of Iowa 
and Aetna of Georgia are considered two carriers)   
  HealthCare.gov currently lists 5,561 open products (products open for enrollment) 
from these carriers  2,030 in the individual health insurance market and 3,531 in 
the small employer market 
  These 5,561 products break down into many more insurance plans  many of 
these products offer multiple variations of co-insurance, copayments, deductibles, 
etc.   
  Another way of saying this is that in October, when HealthCare.gov will start 
providing price estimates, these 5,561 products will turn into many more plans, 
because for each product, each combination of co-insurance, copayment, and 
deductible will have a different price estimate 
  We will continually add to and refine this inventory of insurance products over 
time 
 
Q:  What information does HealthCare.gov have on each coverage option? 
 
  For Medicaid, we provide a list of services covered and special program notes that are 
relevant to your specific situation, based on your answers to the portals questions, plus a 
link to the state Medicaid website 
 
  For CHIP, we provide a list of services covered and special program notes that are 
relevant to your situation, plus a link to each states CHIP website. 
   
   
Page 5  Health Insurance Portal Launch 
 
  For the new Pre-Existing Condition Insurance Plan (PCIP) created by the Affordable 
Care Act, we provide eligibility criteria and let you know if the PCIP in your state is run 
by your state or by the federal government.  For state-run plans, wherever available, we 
provide cost-sharing information (e.g., deductibles, co-insurance), premium ranges, when 
the plan is open for enrollment, and a web link to the plan.  For the federally-run PCIP 
program, we connect you to the programs site, where you can learn more about the 
programs benefits, premiums, and how to apply 
 
  For other state high risk pool plans, we provide eligibility criteria, cost-sharing 
information (e.g., deductibles, co-insurance), premium ranges, contact phone number and 
link to the plan 
 
  For special options you have in particular situations, such as COBRA, the ability to enroll 
in a spouses plan, and the ability to get coverage under your parents plan until youre 26 
(newly created by the Affordable Care Act), we provide you with a summary of this 
option and connect you as appropriate to websites where you can learn more 
 
  For private insurance plans, we let you know which plans are currently offered in your 
zip code  including (if provided by the insurer) web links to a summary of plan benefits, 
provider network directory, drugs covered,  and the insurers website, plus a contact 
phone number to get coverage and premium information specific to you.  For small 
employers, who today rely primarily on agents for information about available plans, the 
ability to see the full range of small group plans offered will be particularly new and 
important.  
 
  In the event that specific coverage options dont work for you, HealthCare.gov will 
enable you to find affordable care options by providing a link to safety net providers and 
community health centers near you.  
 
  And in October 2010, we will start providing price estimates for private insurance plans, 
along with more detailed information on benefits and cost-sharing (e.g., deductibles, co-
insurance), provided by the insurance carriers.   
 
Finally, in addition to the information above on each type of product, HealthCare.gov also knows 
when different coverage or care options might be applicable to you.  Based on your answers to a 
short series of questions, HealthCare.gov produces a customized menu of potential coverage 
choices tailored to your personal situation (with literally billions of potential personal situations 
supported).   
 
   
  Page 6  Health Insurance Portal Launch 
 
Q:  How are you going to improve HealthCare.gov over time? 
Well be continually refining and adding to the information we provide about coverage options 
for consumers  both public programs, such as Medicaid and the Childrens Health Insurance 
Program (CHIP), and private insurance plans.  Information about State coverage programs (in 
addition to Medicaid, CHIP, and high-risk pools) will also be added in the future.   
In October 2010, well be adding pricing information for private insurance plans, along with 
more detailed information about benefits and cost sharing (e.g., deductibles, co-insurance).  
Prices will be estimates, so consumers will need to check directly with the insurance companies 
to get a final price.  Beyond October, we plan to add more useful information about private 
insurance plans, including the percentage of premiums spent on administrative costs.   
Well also be expanding the Learn About Prevention and Compare Care Quality areas of the 
website with additional information and tools that help you get the best health care and stay 
healthy.     
In the future, we will begin to collect plan performance information from insurance companies 
and other sources (for example, on medical loss ratios and claims payment practices.)  These 
performance data can help consumers make meaningful plan comparisons and informed 
coverage choices. 
 
We are deeply committed to making this site as useful to consumers as possible.  Throughout the 
site, we have embedded the opportunity for users to give us feedback, webpage by webpage, in 
the form of yellow bubbles.  Users can use these bubbles to tell us what they like -- and what 
they dont.  They can tell us what they feel the site is missing.  With their help, we will continue 
to improve the site to make sure consumers are getting the information they need to make smart 
health care choices.