Insurers say the federal health-care marketplace is generating flawed data that is straining their ability to handle even the trickle of enrollees who have gotten through so far, in a sign that technological problems extend further than the website traffic and software issues already identified. Emerging errors include duplicate enrollments, spouses reported as children, missing data fields and suspect eligibility determinations, say executives at more than a dozen health plans.
- The latest round of problems has emerged after a technical bottleneck that blocked many potential customers from accessing the marketplace began to clear this week. People familiar with the development of the exchange said some technical problems improved this week.
- HHS, which is running all or part of the marketplaces in 36 states, has repeatedly declined to answer specific questions about its handling of the rollout, including specific glitches, enrollment figures, or its plans to fix the problems. Health-department officials have pressured insurers to refrain from commenting publicly about the problems, according to executives at four health plans, who asked not to be named. The HHS declined to comment.
- Of 209,000 users who began to register on healthcare.gov on Monday or Tuesday of this week, just over one-quarter finished the process, according to an estimate made by the analytics firm comScore for The Wall Street Journal. In the first week, only 10% did so. The estimates are based on a sampling of Internet users tracked by the company.
- As more of those users attempted to sign up for plans this week, insurers began noticing problems with enrollment data. For now, they say they are largely able to manually correct the errors. But as enrollment increases—up to 7 million consumers are expected to sign up in the next 5½ months—that may not be possible, they worry.
- After realizing that some applications listed up to three spouses in a single family, Blue Cross & Blue Shield of Nebraska, which has about 50 health-law enrollees, had to “stop those enrollments from going through the automated process,” said Matt Leonard, the insurer’s sales manager. “It takes an automated process and turns it into a manual process,” he said.
- Sioux Falls, S.D.,-based Avera Health Plans has called each of its 21 incoming customers to make sure the data are correct. As consumers struggle to navigate healthcare.gov, some health-plan executives worry that only the sickest—those who most expect to need insurance—will persist in seeking coverage. If younger consumers who are on the fence about buying coverage find the process too onerous, insurers may end up with too few healthier members to offset the costs of less-healthy enrollees.
- Tara Seidenberg, a 48-year-old paralegal from suburban Houston with multiple sclerosis, says she is likely to put up with all kinds of hurdles to buy coverage. After days of failed attempts to sign up on healthcare.gov, she is taking a break to wait for the glitches to resolve. She takes medications that cost $4,600 a month and her current coverage won’t be available next year. “I’m pretty much guaranteed to try it again,” Ms. Seidenberg said.
*Modified from a WSJ.com article