Obamacare agency relies on manual back-ups as enrollment rises

WASHINGTON Wed Dec 11, 2013 5:52pm EST

A man looks over the Affordable Care Act (commonly known as Obamacare) signup page on the HealthCare.gov website in New York in this October 2, 2013 photo illustration. REUTERS/Mike Segar

A man looks over the Affordable Care Act (commonly known as Obamacare) signup page on the HealthCare.gov website in New York in this October 2, 2013 photo illustration.

Credit: Reuters/Mike Segar

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WASHINGTON (Reuters) - As online enrollment accelerates for medical insurance under President Barack Obama's health law, the government is relying on manual back-up systems to correct computer errors that could leave some enrollees uninsured, the top U.S. health official said on Wednesday.

Health and Human Services Secretary Kathleen Sebelius described the manual procedure as a temporary measure for software applications that have not yet been built, tested and incorporated into the massive system behind the HealthCare.gov website.

Still missing are an automated system for verifying that consumers who sign up for insurance through HealthCare.gov are actually enrolled with a carrier, and a separate computer function for paying billions of dollars in federal subsidies to insurers on behalf of lower-income policyholders.

"There's a manual workaround for virtually everything that isn't fully automated yet," Sebelius said in hearing testimony before the House Energy and Commerce health subcommittee.

"It just will be manual until the automation is fully complete and we've tested it and make sure it works. But in the meantime, the payment system will absolutely go forward."

The admission appeared to weigh on Sebelius' attempts to tout improvements in the website that was established under the 2010 Patient Protection and Affordable Care Act, commonly called Obamacare. The site provides access to new federal health insurance marketplaces in 36 states.

New data on Wednesday showed about 365,000 people signing up for private insurance nationwide in October and November, and 5 million visitors to the once-hobbled federal website during the first week of December.

Republicans questioned the veracity of the enrollment numbers. Representative John Shimkus of Illinois took issue because Sebelius could not say whether those who signed up through the marketplaces had secured their enrollment by paying their first month's premiums.

"When Amazon.com records a book sold, they record a book sold based on someone who has paid for it, not what is in their shopping cart, not what is on their wish list," Shimkus said. "So our concern is this 365,000 figure is fraudulent because it is not those who have purchased plans yet."

BEHIND-THE-SCENES SCRAMBLE

Relying on a manual process to verify enrollment could lead to a new political backlash next year for Obama, who has already been criticized over several million people who received cancellation notices last month for existing health plans that do not meet Obamacare's consumer protection and benefit standards.

"Based on current trends, it's likely that more individuals will have lost coverage on January 1 than will have gained it under the law," said Representative Joe Pitts of Pennsylvania, the House subcommittee's Republican chairman.

Pitts' claim quickly came under attack from Democratic Representative Henry Waxman of California who called it "just not true" and accused Republicans of trying to score political points rather than being concerned about the uninsured.

But the administration and insurers are already undertaking an intensive effort to make sure people who sign up for coverage do not find themselves uninsured in January when coverage takes effect.

"In the early days, there were a serious number of errors," Sebelius said. "And we are in the process of actually hand-matching individuals with insurance companies."

The problem is that the federal system creates errors in computerized enrollment files that it sends to insurers whenever people sign up for coverage. Some files never arrive in the insurance company systems.

Insurers say the danger is that error-ridden files will cause the system to miss enrollees, who could wind up going to a doctor thinking they have coverage when they do not. And the problem could become more pronounced this month if enrollment numbers skyrocket into the millions, as some expect to happen ahead of a December 23 deadline for January 1 coverage.

The administration has already acknowledged that 1-in-4 insurance applications to HealthCare.gov were transmitted inaccurately to insurance companies in October and November, a period when about 137,000 people signed up for insurance in the federal marketplace, according to government data released on Wednesday.

(Additional reporting by Eric Beech; Editing by Karey Van Hall and Grant McCool)

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Comments (24)
AZreb wrote:
Hope the enrollees have read the fine print – especially the deductibles and the doctors and hospitals they can use. The monthly premium may be low, but then you have to reach the deductible before any relief is given – plus, many major hospitals are off the list and if you have a major medical emergency you may end up in a hospital that does not have the equipment or specialists you need.

Dec 11, 2013 9:09am EST  --  Report as abuse
JohnDD wrote:
So, how many have PAID? Until they paid, and until the whole application is approved by the insurance companies, you have no insurance. This whole thing about number enrolled is a bit of a red herring. You need to pay to get insurance….it’s not free. When will the Obama administration start to give out that number. We know 5 million lost insurance who had been paying for it, but how many have paid for this supposedly superior insurance? Numbers folks, numbers!

Dec 11, 2013 9:25am EST  --  Report as abuse
4825 wrote:
Obamacare is a wonderful thing for the insurance companies but sucks for most American families. That is why Obama lied to you umpteen times when he talked about the plan. If he told you the truth he knew you would not like the plan and he wanted to shove it through one way or another. That is also why lame, Nancy Pelosi lied to you and told you that “we have to pass it to know what is in it”. Obama and Pelosi, along with Harry Reid need to go. They snowed a lot of good people into believing a bunch of hype, all to the benefit of their buddies in the insurance industry.

Dec 11, 2013 9:44am EST  --  Report as abuse
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