D.C.’s Obamacare fail: Prices won’t work until November

September 25, 2013

(PAUL J. RICHARDS - AFP/GETTY IMAGES)

Just days away from launch, the District of Columbia's health marketplace is announcing a pretty significant delay.

While the D.C. Health Link will launch a Web site on October 1, shoppers will not have access to the their premium prices until mid-November. The delay comes after the District marketplace discovered "a high error rate" in calculating the tax credits that low- and middle-income people will use to purchase insurance on the marketplace.

The insurance marketplaces, if working as plan, are supposed to spit out an estimate for a tax credit after a shopper enters in some basic information about where she lives and how much she earns. In the District, that won't happen next month. Instead, the eligibility determination will be made "off-line by experts" by early November.

The delay will be less significant for people who likely qualify for Medicaid in the District, which covers everyone below 200 percent of the poverty line (about $22,000 for an individual). In cases where someone is found likely eligible for that program, D.C. Health Link spokesman Richard Sorian said they should get a determination with 24 hours.

The idea is to make sure that potential Medicaid enrollees–who could gain benefits right now–are processed quickly. People who qualify for tax credits, and for whom benefits wouldn't start until January, they'll have to wait a bit longer.

For a bit more background, here's what the D.C. Health Link sent out at 4 p.m. today:

DC Health Link is not currently deploying the function that makes new Medicaid eligibility determinations and calculates tax credits for purchase of private insurance due to a high error rate discovered through extensive systems testing.

 

People seeking Medicaid coverage or tax credits will be able to use DC Health Link to create an account and submit an on-line application. Their initial eligibility determination will be completed off-line by exw

 

Those people who have submitted applications will automatically receive an eligibility determination for tax credits in early November.  Based on an accurate premium reduction calculation a consumer will have ample time to make an informed decision about which health plan to enroll in.  Coverage will begin Jan 1, 2014, as long as payment is made by December 15.

A spokesman for the D.C Health Benefit Link tells my colleague Lena Sun that this glitch is specific to the District's marketplace, and separate from reports on a similar challenge facing the federal marketplace.

This certainly is not good news for Obamacare, especially in the wake of the other reports on similar glitches at the federal level. The Obama administration has repeatedly promised that, starting on October 1, all Americans will be able to purchase insurance coverage on the new marketplaces. In the District of Columbia, that won't be true.

Will it matter for who gains coverage? That's a bit more difficult to gauge. The D.C. Health Link says it will get eligibility determinations out by early November. Since coverage on the marketplaces doesn't begin until January 1, that would still give people enough time to sign up for a plan by day one. What's hard to gauge is, after this clunkier experience, whether they'll still want to enroll.

Comments
Show Comments
Most Read Business
Next Story
Ezra Klein · September 25, 2013