HealthCare.gov still screws up 10 percent of enrollments

December 6, 2013

Every day, usually about 2 p.m. or so, the Centers for Medicare & Medicaid Services hosts a half-hour-long call on the status of the insurance marketplace. Now, every day, we here at Wonkblog will update you on what the federal government told us about how Obamacare is going. Without further ado, here is what we learned today.

(REUTERS/Jessica Rinaldi)
(REUTERS/Jessica Rinaldi)

About 10 percent of Obamacare enrollment files have errors. Medicare spokeswoman Julie Bataille confirmed that the agency believes about 10 percent of the health law's enrollment files -- known in insurance-speak as 834 transmissions -- have some kind of error. (That figure was reported earlier Friday by Jonathan Cohn at The New Republic.)

This is a lower error rate than during the first two months of open enrollment, when the agency estimates about one in four of the transmissions had a problem.

Bataille said there are essentially three problems affecting the 834 transmissions. There are situations where HealthCare.gov doesn't generate any transmission at all, times when it generates duplicate transmissions and situations where the transmission occurs but contains inaccurate information.

"Because there have been a number of different problems, it has made it difficult for us to quantify the total number of forms and errors over time," Bataille said.

Bataille stressed that these figures are preliminary, gathered using a sample of 834 transmissions that the federal exchange has sent out.

"There is a range of reasons of why its difficult to categorize and count," Bataille said. "If you look at range of issues of what we’re dealing with... each is a different set of circumstances. We have to very methodically and precisely go through individual transactions at a granual level in order to reconcile the information."

Bataille was not able to specify which category showed the greatest number of problems -- for example, whether the dominant problem was that 834s weren't being generated or that they were being generated but with missing information. That knowledge will likely be important to understanding the scale of the problem. It's arguably a lot easier to fix an enrollment file with inaccurate information than deal with one that was never generated in the first place.

Insurers meet daily with the federal government to work together on this problem.

Bataille said there is a daily conference call and webinar where health law and industry leadership discuss back-end problems. "It's lead by QSSI [the general contractor] and includes participation from CMS leadership, as well as the plans themselves, in order to have a back-and-forth conversation about the specifics of the information and transaction forms," Bataille said.

The errors will not change the enrollment number count. 

This was an important question from Laura Green at the Palm Beach Post: If one-quarter of the enrollment forms were inaccurate, would the Department of Health and Human Services need to revise its enrollment count?

Bataille said no.

"Despite the fact we know there were issues with transaction, that does not impact the enrollment numbers," she said.. "We’re working to reconcile that information so that all consumers who applied are able to successfully" access their insurance coverage.

 

 

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Lydia DePillis | December 6, 2013