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One insurer’s view of Obamacare

Friday afternoon, I spoke with someone in the insurance industry who's overseeing his company's integration with the federal insurance marketplaces in a number of states. "I've never seen a project go this poorly," he said. "But then, I've never been part of one this grand in scope."

(Karen Bleier/AFP/Getty Images

He confirmed, as others have, that his insurer is seeing a lot of bad data come in from the exchanges. Payments are getting rejected. Enrollee information is coming in wrong. Membership is proving tough to validate.

"What our company, and I'm assuming others, are doing is throwing people at it," he said. "We're overcoming the tech flaws with manual reviews and manual rigor and manual processes. That's fine right now, but when you start looking at the scale of what the Obama administration wants to do, that's just not going to scale up."

What that means, oddly, is that if the federal health-care exchanges Web site traffic problems were solved Friday afternoon, it might be a disaster for the law as insurers would be flooded with applications that they couldn't trust. The question is whether the data problems can be fixed as quickly as the traffic problems are abating.

The good news, he said, is "the quality of data coming from the exchanges is getting better." Which isn't to say the problems are anywhere near solved. There's still plenty of duplicate data and corrupted data coming in. But they've definitely seen an improvement over the last few days.

He thought the mood had swung a bit far toward gloom. "There's a lot of negative talk now, and people feeling down," he said. "Things will stabilize at some point in time as they always do." I asked whether he thought it likely that the law or significant provisions within it would need to be delayed. "I think that's overly pessimistic," he replied.

An issue on both sides, he said, is that though there are very good people working at the Department of Health and Human Services and very good people working in the insurance industry those people don't tend to go into the IT departments. Really good technologists don't want to work on the kind of computer systems and software development cultures that dominate in places like HHS or the insurance industry.

"Kids coming out of MIT don't want to work on mainframe technology," he said. "They go into start-up firms. They want to be entrepreneurial. So there's a big gap in terms of technology talent."

It's worth saying that if you've talked to one insurer you've talked to one insurer. Industry consultant Bob Laszewski, who has a more global view, e-mails that the insurance carriers he's talking to "are reporting no improvement in enrollments and no improvement in [data issues]."



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Brad Plumer · October 18, 2013

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