State exchanges hitting data snags, too
Even in states where Obamacare enrollment is booming, insurance companies are running into significant behind-the-scenes technical glitches that could threaten Jan. 1 health coverage.
Many of these 14 states and the District of Columbia have been eager to tout the success of their own exchanges compared with the bungled federal portal, but they now appear to be worrying about back-end problems similar to those afflicting HealthCare.gov.
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It’s a new twist in the unfolding saga of so-called 834 forms — industry jargon for the application files that insurers receive when someone signs up for coverage through an exchange.
Insurers in Kentucky and New York, for example, say they’ve received flawed 834 enrollment forms from their local exchanges, though the extent of the errors is unclear. Washington state has already had to correct thousands of 834s with faulty information about federal tax credits.
Several state exchanges waited until late last month to even start sending application data to insurers, meaning potential errors haven’t had much time to surface.
At the least, these issues run counter to the popular storyline: that states’ enrollment systems have vastly outperformed the Obama administration’s effort. At the worst, they could endanger coverage for thousands of people who think they’re already enrolled for the start of 2014.
“While there is significant variation from state to state, health plans in many state-based exchanges are seeing similar problems with enrollment files,” Robert Zirkelbach, spokesman for America’s Health Insurance Plans, said Thursday.
It’s uncertain how deep the problems go, in part, because the states themselves aren’t sure — and are reluctant to divulge much about their technical challenges.
“We don’t have a clear picture of how things are out in the states,” said Caroline Pearson of Avalere Health.
Until now, concerns about state-run exchanges focused mostly on the places with very public breakdowns in just getting people into their system. Oregon, for one, only recently claimed its first enrollees, while Colorado has faced major bottlenecks in its system. Hawaii recently replaced its exchange director following a series of tech woes, and Vermont is reportedly withholding funds from its lead contractor, CGI, which also built the biggest chunk of HealthCare.gov.
As for California, its program has yet to process as many as 35,000 applications that were submitted by fax, Fox Business Network revealed Thursday afternoon.
Yet problems with the back end of these 15 exchanges have received little attention. Not even the programs considered to be the nation’s best — including Kentucky’s Kynect and New York State of Health — seem immune.
“In general, the situation is the same for the state-run exchanges as it is for the federally facilitated exchanges,” said Tony Felts, a spokesman for Anthem Blue Cross and Blue Shield, one of Kentucky’s major insurers. “As far as the quality of the data that’s coming in, I can’t say that everything has been completely accurate. Nor has everything been completely inaccurate.” It’s too early, he added, to know if the problems have been solved.
The office of Senate Minority Leader Mitch McConnell, an ardent Obamacare opponent, has been asking insurers if they’re getting the information they need to enroll people. “We have been told that although a Kentuckian may believe they’ve enrolled in a plan on the exchange, this information is not necessarily being reported to the insurer in a way that guarantees coverage,” said McConnell spokesman Donald Stewart.
Although a Kynect spokeswoman said the exchange has dealt with only “minor issues” since it started sending enrollment files to insurers a month ago, she didn’t indicate whether those issues had resulted in flawed forms or if they’d been resolved.
The concerns cut to the heart of an otherwise sterling narrative in the Bluegrass State. Democratic Gov. Steve Beshear talked up his state’s effort during a visit to Capitol Hill on Thursday and challenged critics of the health law to visit Kentucky’s exchange operation. “I want to publicly invite our entire federal delegation to come back to Kentucky … and come over to our center, our nerve center where we’re running this program, and see for yourself what is going on,” Beshear said. “When you see that, I think you’ll quit saying, ‘This will not work,’ and ‘Kentuckians don’t want it.’”
As with HealthCare.gov, the problems stem from an obscure insurance industry process known as an 834 transmission. When a person signs up for insurance online through either a state- or federal-run exchange, the system is supposed to generate an 834 form and submit it to the selected insurer, which then processes the form and places the individual in coverage.
Read more: http://www.politico.com/story/2013/12/obamacare-state-exchanges-technical-glitches-100757.html#ixzz2miBUHYca
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