Obama Administration: Thousands Of HealthCare.gov Enrollments Never Made It To Insurers

The Washington Post is reporting that a government analysis shows approximately 15,000 enrollment files from HealthCare.gov never made it to insurers.  Additionally, and no list of the affected people exists.

Almost 10% of enrollments failed to make it to insurers in the first half of October.  That number increased to 15%, and then declined “steadily,” in November.  Earlier this month, enrollments fell to less than 1% as software fixes took hold.

HHS has provided insurers with massive files of enrollment data to reconcile with their own files, but “while insurance plans could plausibly correct inaccurate data, they could not get coverage to a subscriber they did not know existed.”

Exacerbating the situation:

  • Inadequate Guidelines:  The New York Times says insurers believe the government has overstated fixes to the Federal exchange website.  For example, many problems they reported to a CMS help desk “remained unresolved.” The government’s message to insurers: “do whatever you have to do to maximize enrollment and to provide coverage by Jan. 1 to anyone who wants it,” and “details and work out financial arrangements with the government” can come “later.”
  • The Exchange:  The Wall Street Journal reports that there are many errors in the Federal health insurance exchange’a application system.  The federal government is now predicting that perhaps one in five applicants were inaccurately assigned to either Medicaid or the private plans or received denials that were wrong. Other people (like children) are just missing from enrollments.  The Journal also reports that such problems could lead to chaos on Jan. 1, as people start to use insurance at doctor’s offices, in hospitals, and in pharmacies.  Comments from some insurers and Federal officials say that the most problematic applications are those for complex tax or family situations.


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