Despite Website Fixes, Fears Grow that Obamacare Numbers Don't Add Up
Monday, 02 Dec 2013 07:04 AM
"We're looking at 1 million people signed up in the amount of time they’re expecting," reporter Rebecca Jarvis said Sunday on ABC's "This Week."
And if that pool is dominated by older people, Jarvis noted, premiums in 2015 could skyrocket.
The administration had been counting on younger, healthier people signing up to keep costs down for older people who use health services more often. But early reports showed young people either not signing up – possibly opting for a less-expensive fine – or signing up for Medicaid, which is funded by taxpayers.
The White House released a statement Sunday morning that it had met its self-imposed November 30 deadline to make major repairs to the site, which barely worked for the first month after its October 1 launch. Reporters testing the site, however, still found it crashed.
Even with the repairs, the Obama administration is asking people not to flood the site. It is said to be capable of handling 50,000 people at a time now, or 800,000 per day.
ABC's numbers used only the current known capacity of the website and not the projected 800,000 per day. The administration originally set December 15 as the deadline to sign up for coverage that would take effect January 1. But because of the technical problems, that deadline was extended to December 23.
Open enrollment lasts until March 31.
After the disastrous initial rollout, federal officials reported that only about 23,000 people signed up for private insurance through HealthCare.gov. Even worse, just 150,000 signed up for private plans through both the federal and state-based exchanges.
But as the states addressed their own website glitches, their numbers seemed to go up. Kentucky, a Republican stronghold that decided to expand Medicaid and build a state-based exchange, has been an early success. Kentucky announced it would add an 80 percent increase in capacity by Dec. 2, and that more than 60,000 people had enrolled in coverage by Nov. 26.
"There is great variation by state," Stan Dorn, a senior fellow at the Urban Institute, told USA Today. "In states that are enthusiastically implementing the law and trying to implement the state exchanges and trying to increase enrollment, there's going to be greater numbers."
Still, those numbers don't seem to be at the level needed to make Obamacare work.
In Colorado, enrollment figures are below the state’s own worst-case projections. The lowest-level mid-November enrollment projection was 11,108; the middle range 20,186 and highest hitting 30,944, the Denver Post reported.
In Maryland, meanwhile, the situation got so bad that the exchange board decided to let insurance companies deal with payments directly.
Its first full month of operation saw only 1,278 people signed up for the state-run option. During the first week in November, 465 people signed up.
The low numbers have some questioning whether Maryland will make its goal of signing up 800,000 uninsured residents during its first year, Fox News reported. The state also delayed its small business marketplace enrollment deadline until April.
“The complexity of the challenge has been clearly more than we anticipated,” Joshua Sharfstein, Maryland’s health secretary, said in a statement. “Our focus is on improving the performance of the system. We are really looking for significant improvement.”
Along with Kentucky, New York and California seem to be the best hope for Obamacare.
New York's enrollment numbers showed 76,177 had enrolled in a health plan, up from 48,162 on Nov. 12. And 257,414 people had completed their exchange applications, up from 197,011. New York officials expected 1.1 million to sign up by the end of three years.
California has said enrollment applications grew from 334,027 as of Nov. 16 to 385,556 as of Nov. 23.In Washington, more than 150,000 have started applications.
Insurers, meanwhile, also are very concerned about "back-end" issues, according to Karen Ignagni, president of America's Health Insurance Plans. Specifically, they want to know if the non-consumer portion of the site that ensures insurers receive subsidy payments will be ready by Jan. 1. There have also been considerable problems with "834" forms, or the process by which the government gives insurers data about whom they're insuring, she told USA Today. That will have a huge effect on numbers.
"HealthCare.gov and the overall enrollment process continue to improve, but there are significant issues that still need to be addressed," Ignagni said. "Health plans will continue to support federal and state officials' efforts to fix the ongoing technical problems and improve the direct enrollment process so that consumers can get the coverage they need."
"The real challenges remain, and that's downstream," said Rick Howard, research director for the technology consultant Gartner. "The real error rate will be in the billing transactions and how accurate the billing information is and how accurate the premium calculation is."
Republicans plan to highlight Obamcare's failures in the 2014 midterm elections, and many Democrats in tough elections are distancing themselves from the program they once touted.
In addition to the website failures, the program has come under fire because President Barack Obama promised people they could keep insurance plans and doctors they like. That has proved to not always be the case.
And some people who currently have insurance are being forced into plans that cost significantly more.
The employer mandate, which affects people who get insurance through their jobs, was delayed until 2014. Republicans charged that this was to move the full impact on the public until after the 2014 vote.
The White House denied that, but on November 22 confirmed that the 2015 enrollment period would be delayed by a month to give insurance companies more time to calculate their premiums.
That would move enrollment to November 1, just three days before the midterm elections.
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