Insurers: Problems with ObamaCare Mean Some Will Not Have Coverage

Much has been observed about the failure of the ObamaCare exchange websites: the website “glitches” Americans have experienced when attempting to sign up, the fact that, within just one week, the system has been shut down for “repairs,” and the warnings by both technology “gurus” and business leaders of the strong likelihood that Americans’ private information is at risk when they try to purchase health insurance at the online marketplaces.

But, what happens if you do finally get to enroll?

Bloomberg News reported Tuesday that insurers are finding they are receiving “faulty and incomplete data” from the federally-run health exchanges, a situation that could mean some Americans who think they have health insurance coverage, actually do not. Whether they find that out before they need to use their health insurance is another matter.

Insurance industry consultants have reportedly indicated that insurers are receiving electronic files they either cannot open or that have such a vast amount of missing data on new enrollees that the files are unusable.

Bob Laszewski, an insurance-industry consultant from Arlington, Virginia, said that some insurers have been forced to fix entries by hand.

“If we don’t see substantial improvement by the end of this week, then I would throw up the yellow flag,” said Dan Schuyler, a consultant who advises states and insurers on the exchanges. “If we don’t see it in the next two to three weeks, it’s time for red flags. The concern is some people could get to Jan. 1st, and not have coverage.”

As Bloomberg News reports, however, the Obama administration isn’t commenting either about the difficulties experienced on the exchanges or the number of Americans who have actually been able to enroll through the healthcare.gov portal.

According to Laszewski, though the number of Americans signing up for health insurance in the exchanges is apparently small enough so that insurers have been able to “fix bad data file by file,” later on this may not be the case.

“If you’ve only got a dozen bad enrollments, that’s OK, but what are you going to do when you have 200,000 bad enrollments?” he asked. “What we’re seeing in public is the web portal, which is a mess. It is just as bad behind the wizard’s curtain.”

Similarly, CNBC reported late last week that only one in a hundred applications on the federal exchange contains enough data to actually enroll the applicant in an insurance plan. According to insurance industry sources, some of the difficulties are related to how the exchange’s software collects and verifies an applicant’s information.

“It is extraordinary that these systems weren’t ready,” said Sumit Nijhawan, CEO of Infogix, the company that handles data integrity for some of the major insurers such as WellPoint and Cigna.

According to these experts, if the federal exchange’s success rate does not improve within the next month, HHS could be dealing with a situation in January in which relatively large numbers of people believe they have health insurance coverage, but actually still have an unprocessed application.

The fact that some Americans will find out they are uninsured when they experience a medical emergency or an unplanned hospitalization sounds like a nightmare.

Nijhawan adds, “It could be a public relations nightmare,” as well.

 


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