Healthcare.gov has been miscalculating premium subsidies. The website has been using the wrong year in determining poverty guidelines and consequently provided inaccurate information to thousands of enrollees as to whether they can receive government subsides.
The calculator supplied on the site has been scrambling the 2013 poverty level year and the 2014 year. Most federal programs are using 2014 poverty levels as the basis for these kinds of estimates, but the Affordable Care Act dictated that the 2013 guidelines be used this year because sign-ups began last year. Unfortunately, HealthCare.gov continued to use the higher 2014 guidelines.
The result is that people whose incomes are just above the high end of the 2013 poverty guidelines are being told they qualify, but find out later that they don’t. Moreover, those just over the low end are being told that they don’t qualify. If they want to get the subsidy, they will have to ignore that message and click through to use another tool on the site, then they will find out they do qualify.
“It’s just another one of those, ‘Why did they do that?'” Robert Laszewski, president of Health Policy and Strategy Associates, told the Philadelphia Inquirer. The new glitch for an already beleaguered website comes at an inopportune time for the Obama Administration. While the administration spends time tackling the problem, the enrollment deadline is only ten days away. The White House and other branches of the administration are hustling to get people enrolled but delivering inaccurate information, and telling people they don’t qualify for subsidies isn’t what the doctor ordered.
Meanwhile, the American Medical Association (AMA) expressed some alarm in reaction to the revelation that under the Affordable Care Act, doctors will be responsible for assuming greater risk than insurance companies if patients stop paying their healthcare premiums. One aspect of Obamacare mandates that patients have a 90 day grace period for not paying their insurance premium while still being eligible for doctor and hospital assistance. If the patient incurs services and then walks on his bills, insurance companies are only liable for the first 30 days of care, leaving the doctors on the hook for the last 60 days.
The president of the AMA, Ardis Dee Hoven, said, “Managing risk is typically a role for insurers, but the grace period rule transfers two-thirds of that risk from the insurers to physicians and health care providers.”