Healthcare.gov is Still Sending Bad Health Plan Data

Dec 3, 2013

Photographer: Andrew Harrer/Bloomberg.

Initial reports, like this one from the Kaiser News Service, indicate that the performance of the "front-end" of Healthcare.gov, the side of the website that customers use to submit information, has improved. However, if the entire health plan purchasing process (i.e. filling out the application, determining premium subsidy eligibility, and sending accurate enrollment data to insurance companies) doesn’t work smoothly, then there will be problems when a consumer goes to a clinic or hospital and attempts to use the plan they think they bought.

While the website seems to be handling more consumers with fewer snafus, according to the Washington Post, there continue to be "back-end" problems with insurance companies still getting bad data from the website [h/t Ed Morrissey]:

The enrollment records for a significant portion of the Americans who have chosen health plans through the online federal insurance marketplace contain errors — generated by the computer system — that mean they might not get the coverage they’re expecting next month.

The errors cumulatively have affected roughly one-third of the people who have signed up for health plans since Oct. 1, according to two government and health-care industry officials. The White House disputed the figure but declined to provide its own.

The mistakes include failure to notify insurers about new customers, duplicate enrollments or cancellation notices for the same person, incorrect information about family members, and mistakes involving federal subsidies. The errors have been accumulating since HealthCare.gov opened two months ago, even as the Obama administration has been working to make it easier for consumers to sign up for coverage, the government and industry officials said.

The New York Times adds:

The problem is that the systems that are supposed to deliver consumer information to insurers still have not been fixed. And with coverage for many people scheduled to begin in just 30 days, insurers are worried the repairs may not be completed in time.

“Until the enrollment process is working from end to end, many consumers will not be able to enroll in coverage,” said Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group.

The issues are vexing and complex. Some insurers say they have been deluged with phone calls from people who believe they have signed up for a particular health plan, only to find that the company has no record of the enrollment. Others say information they received about new enrollees was inaccurate or incomplete, so they had to track down additional data — a laborious task that will not be feasible if data is missing for tens of thousands of consumers.

In still other cases, insurers said, they have not been told how much of a customer’s premium will be subsidized by the government, so they do not know how much to charge the policyholder.

Sending inaccurate data has plagued Healthcare.gov since its October launch.

What’s more, Bloomberg reports that the premium subsidy payment system isn’t ready either [h/t Jim Geraghty]:

Parts of the Obamacare enrollment system used to pay insurers are being pushed back from January in the latest technology delay for the president’s U.S. health care overhaul.

The administration is setting up a temporary process to send companies the federal subsidies used to help millions of Americans buy coverage because the online system won’t be ready as planned, said Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services. Insurers will estimate what they are owed rather than have the government calculate the bill.

The Department of Health and Human Services (HHS) can brag that it’s “working with the velocity and discipline of a high-performing private sector company” (which doesn't speak well of how well they were working before), but such bravado is meaningless unless all the parts of Healthcare.gov function correctly. Healthcare.gov isn’t there yet.

[H/t memeorandum]

Subscribe for Updates

Email:
First Name:
Last Name:
Frequency
 Daily   Weekly

The Challenge Cup: Follow the Global Tournament

Join the Discussion