Insurers are scrambling to finalize hundreds of thousands of last-minute Obamacare applications as the Jan. 1 start of coverage approaches, dealing with the fallout from persistent HealthCare.gov flaws that are invisible to most of their new customers.
Whether the health plans succeed will help determine whether the White House is popping champagne corks over the New Year’s Day start of coverage or girding for another round of horror stories about people who think they are insured — but find that there’s no record of their enrollment if they need medical care in the next few days or even weeks.Continue Reading
It’s unclear how many of the behind-the-scenes enrollment snags on HealthCare.gov have been resolved. Insurers have long complained of receiving duplicate or erroneous applications from thousands of new customers, and in many cases, receiving no application at all. They’ve been painstakingly trying to match their records with those of the health insurance exchanges.
“The front end of the site is now finally working quite well — in contrast to the very serious back-end issues that still remain,” said Robert Laszewski, an insurance industry consultant. The “front end” is what consumers see. The back end involves the health plans and the administrative work to finalize enrollment in the plans the customers selected.
The tech problems aren’t the only worry. The administration also rankled insurers with a series of last-minute changes, delays, modifications and exemptions from Obamacare’s new requirements that pushed back enrollment deadlines right up to Christmas Eve for most people — with some extra time to help undisclosed numbers of people who tried to sign up on time but got snagged one way or another on the website.
“CMS has been working closely with issuers on an intensive process to compare enrollment data and inform consumers about the steps they need take to ensure their coverage starts Jan. 1. We are also working closely with state insurance departments, health providers, pharmacies and consumer advocates, and we have a robust casework process to help consumers transition to coverage in January,” a spokesman for overagethe Centers for Medicare & Medicaid Services said late Monday.
Administration health officials held a call with insurance company executives last week about the challenges in processing a flood of late sign-ups in a shrunken time frame. Some carriers have warned that they just don’t have the personnel to sort through it all by Jan. 1.
“The insurance companies who have the biggest enrollment may not have enough resources to enroll everyone properly — or enough time to correct errors, before Wednesday,” Sheryl Skolnick, an insurance industry expert at CRT Capital, said in an email. “We’ll find out if there is a flood of newly insured into hospitals on 1/1 or doctors’ offices/urgent care clinics on 1/2/14 who think they are insured but aren’t. That’s when the real work matching up the who with the what will take place.”
CMS, the agency overseeing HealthCare.gov, didn’t give any further details. America’s Health Insurance Plans — the industry’s main trade association — had no comment on Monday, although a spokesman said it might give an update later in the week.
Insurers have often been less optimistic than the Obama administration about claims of progress.
“There is the concern that one week, less actually, is not enough time to get everyone who did go through the enrollment process at the last minute into the system on Jan. 1 and ready to be insured,” added Skolnick. “That’s probably, in my view, the biggest concern.”
The Obama administration is still recovering from the flawed launch of HealthCare.gov, but the conditions for a turnaround seemed in place this week: More than a million people had selected plans through the federal exchange that serves 36 states. Final numbers haven’t been released for all the state exchanges, but about another million signed up there in time for Jan. 1 coverage. That’s fewer than the 3 million the White House initially hoped for by Jan. 1, but still a sign of momentum after the disastrous Oct. 1 launch.
The administration also foreshadowed a PR blitz highlighting stories of consumers accessing coverage for the first time or discovering, thanks to their new insurance, that they have health problems in need of treatment.
But unresolved problems with the enrollment process could revive damaging storylines about the health law, which are likely to be highlighted all the way through next November’s House and Senate elections
The states running their own exchanges also have taken steps to prepare customers for the possibility that their applications may not have been processed in time for Jan. 1 coverage.
Washington state’s exchange warned that some customers using their new insurance plans in early January may run into problems if their information hasn’t worked its way through the system to the health plan yet. Washington, like some other states, is allowing customers to pay through Jan. 15 for coverage that can start retroactively on Jan. 1. Many plans around the country have pushed back their deadline to Jan. 10.
“We want our customers who may be accessing their new coverage in January to be aware of the process for utilizing health benefits before they are fully enrolled,” Richard Onizuka, CEO for Washington Healthplanfinder, wrote in an emailed statement. “Some may incur out-of-pocket expenses if using services prior to their enrollment information being fully reconciled with their new health insurer.”Jennifer Haberkorn contributed to this report.
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