Obamacare

Obamacare's State-Based Insurance Exchanges Are Also Producing Enrollment Errors

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Healthcare.gov

Many of Obamacare's defenders have argued that the law works where there's political support to make it work, particularly in states like California, which chose to create its own health insurance exchange under the law. The experience in states like Maryland and Oregon, both of which were proactive in creating their own exchanges but had serious trouble anyway, complicates that narrative.

So does this report in today's Politico, which notes that the state based exchanges may be subject to some of the problems with 834 transmissions, which contain enrollment data, between the state exchanges and participating insurers—the same sorts of problems plaguing the federal exchange system. 

Insurers in Kentucky and New York, for example, say they've received flawed 834 enrollment forms from their local exchanges, though the extent of the errors is unclear. Washington state has already had to correct thousands of 834s with faulty information about federal tax credits.

Several state exchanges waited until late last month to even start sending application data to insurers, meaning potential errors haven't had much time to surface.

Right now it's too early to say how serious or widespread the problem is within the state-run insurance portals. But even in Kentucky, which is widely viewed as one of if not the best-run exchange in the country, there appear to be problems. 

"In general, the situation is the same for the state-run exchanges as it is for the federally facilitated exchanges," said Tony Felts, a spokesman for Anthem Blue Cross and Blue Shield, one of Kentucky's major insurers. "As far as the quality of the data that's coming in, I can't say that everything has been completely accurate. Nor has everything been completely inaccurate." It's too early, he added, to know if the problems have been solved.

The existence of these data transmission errors means that even in states where the exchanges are reportedly working fairly well, some consumers who believe that they have enrolled in exchange-based insurance may eventually find out that they are not enrolled, or that their enrollment data is incorrect. 

Are these problems fixable? Perhaps. An administration source tells The New Republic's Jonathan Cohn that the error rate within the federal exchange system was one in four in October, but has since been lowered to one in ten. That's an improvement, but it's still a huge problem, especially since sign-ups are happening at a much faster rate this month than they were in October. Certainly it's nothing for the administration, or the law's defenders, to be proud of. Imagine if, a few weeks prior to the October launch of the exchanges, it had become clear that the exchanges would incorrectly transmit 10 percent of applications, and in at least a few cases, not transmit any information at all. It would have been viewed as a significant problem. That it's now viewed as a sign of improvement only shows how poorly the initial launch went. 

Even if the system eventually ends up working perfectly for new enrollees, there were still be a large group of people whose information wasn't transferred accurately. Cohn's administration source guessed that the number of people in that category is somewhere in the tens of thousands. Depending on how long long the errors take to fix, how many sign-ups occur in the meantime, and how widespread the transmission errors are in the state-run exchanges, that number could turn out to be a lot higher. 

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  1. So remember back when you had an insurance claim, and you had to make a lot of long and frustrating phone calls to get an insurance company to pay for your tests or your surgery? That’s going to look like the Golden Age when people start to file claims and find out they were never really insured because their enrollment was never processed correctly. I can’t imagine how terrible it would be to call an Obamacare navigator and try to get them to hunt down the problem and fix it.

    I think we are in for another wave of really bad stories in the not-so-distant future.

    1. That’s the great thing about OCare. Fixing the enrollment problem just ramps up the higher-premium and doc shock problem.

      1. And the no-doubt-coming identity theft problem.

    2. Maybe all these problems were put there on purpose, so we will focus on them and not on how inherently terrible the system will be when it actually works as designed.

      1. This assumes that they had the presence of mind to construct an effective obfuscation.

        It’s why I laugh at most false flag accusations. I’ve done work for the government. The competence and intelligence required to pull off most of what gets blamed on conspiracy simply doesn’t exist within our system. Competent people get weeded out very quickly and aren’t allowed to make any actual decisions.

  2. an Obamacare navigator

    But, jerbz, created right out of thin air! It’s progressive magic!

    1. The SEIU approves of this message!

  3. the law works where there’s political support to make it work, particularly in states like California, which chose to create its own health insurance exchange under the law.

    Overlooking, of course, the fact that the CA OCare exchange is building a toxic pool, with young ‘n’ healthy marks under-represented, and the older and sicker over-represented.

    1. There’s enough Obots in CA to produce workable numbers now. That pool of cheerleaders will get used up pretty quickly and those who are not ‘The New Soviet Man in Service of Obo’ will begin to color the enrollments and the reports from the field.
      Right now, TEAM is carrying it.

      1. There’s enough Obots in CA to produce workable numbers now.

        Well, maybe, but certainly not yet.

        The exchange only gave a breakdown by age for October enrollment. For that month, 56% of health plan enrollees were 45 to 64 even though that age group represents only 25% of the state’s population.

        http://www.latimes.com/busines…..z2migXzH1F

        1. In raw signups let’s say there are enough obedient OFA types in CA. But surely when they hit the sticker shock, they will quietly slink away. I assume a lot of these numbers are kids who haven’t had to pay a dime yet.

          1. Yeah, just checked the article. Young are 23% of sign-ups. That is way different than 23% of paid enrollments. I say it turns out less then 5% are the “young invincibles”.

  4. Totally Unexpected!!11!

  5. I really didn’t think it would be this bad. And I thought it would be pretty bad.

    1. It would be truly hilarious, were it not for the fucking it’s going to do with so many lives, including ending some of them.

  6. 10% is a huge error rate. If they meet their goal of 40 million sign-ups without bringing that down, that is 4 million errors. That is larger than the populations of Wyoming, Vermont, D.C., North Dakota, Alaska, South Dakota, Delaware, Montana, Rhode Island, New Hampshire, Main, Hawaii, Idaho, West Virginia, Nebraska, New Mexico, Nevada, Utah, Kansas, Arkansas, Mississippi, Iowa, Connecticut, Oklahoma, and Oregon. That is almost half the States in the Union.

    1. Here’s an editorial cartoon idea. The Obamacare air traffic control tower, with planes colliding in the background, while someone in the tower says: “Good news! We have the error rate down to 10%!”

      1. Would it have lots of labels like those Bok masterpieces?

        1. I think a caption of “The Obamacare control tower” would be all that’s needed.

  7. But they have still captured all that personal data, which I have come to believe is the principal goal. Problems on the back end, and the actual provision of insurance coverage, are unimportant.

  8. most of my experience with government run websites is through the military.

    Recently for no reason my user account got deleted, so did my boss’ account. So we had to limber up and jump through the hoops just to be able to use military computers. Furthermore many of the sites are often unavailable when they are needed or run very slowly because they can’t handle the traffic.

    And these websites have been up for years run by mostly competent people and yet still have massive, sometimes critical, problems.

    Btw sorry for being so vague but I must be since military personnel don’t get first amendment protections for speaking out against “dear leader”.

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