A dispute over health insurance “orphaned files” has erupted between insurance companies and the Obama Administration, with the insurers saying there is a major problem looming ahead while the feds say not to worry.
Orphaned files occur when customers enroll with the government but the insurance companies have no record of the files. Because customers of ObamaCare start their insurance coverage this month, the problem has begun to surface.
Insurers are finding cases where the government has assigned the same identification number to different customers and also “ghost” files, the opposite of orphan files, in which the insurer has the record of enrollment but there is no record or file with the government. The reason “orphan” files are so problematic is because insurers have to check their records against the governments’ manually, something Aetna spokeswoman Susan Millerick said will not work as a permanent solution. Insurers expect the problem to get worse with the inclusion of numerous December enrollees in ObamaCare.
Robert Zirkelbach, a spokesman for the industry trade group America’s Health Insurance Plans, said, “It’s an ongoing concern. Health plans can’t process enrollments they haven’t received from the exchange.”
Insurance industry consultant Bob Laszewski said the problem arose because the government gave the green light for enrollees in ObamaCare without fixing the technology first. He added that because insurance cards have been late getting to customers, there will be more reports of orphaned files. He said, “As we go through the month, you bet this is going to be a problem,” he said.
But Julie Bataille, communications director for the federal health care rollout, does not agree that there is a problem, claiming, “We have fixed the issues that we knew were a problem, and we are now seeing nearly zero errors in the work moving forward.” She added that the administration is trying everything to fix the problem.
Blood cancer survivor Sharon Van Daele of Tucson, Arizona, was a victim of the “orphan file” syndrome; her confirmation from her insurer failed to arrive despite the fact that the HealthCare.gov website said on Dec. 22 that she had successfully enrolled. She lamented, “I made all the deadlines, and then I tried to make my payment, but they wouldn’t take it.” An official from the federal Centers for Medicare and Medicaid Services finally contacted Van Daele directly after the Associated Press started questioning what was going on.
Van Daele’s previous coverage ended on Dec. 31, and when no notice came that she was covered, she got instructions from her husband: “My husband told me I shouldn’t leave the house,” she said.