Health insurers getting bad data from healthcare.gov

Summary:Insurance companies tell the Wall Street Journal that they are receiving erroneous application data from the troubled healthcare.gov site.

A story in the Wall Street Journal gives more detail on earlier reports that healthcare.gov, the federal health insurance exchange site created pursuant to the Patient Protection and Affordable Care Act (PPACA, also known as ObamaCare), is sending erroneous data to insurers. The implications could be serious for the applicants.

As the WSJ and other sources have reported, the front-end errors and delays in healthcare.gov have begun to subside. In the process they have exposed other problems.

Those few applicants who managed to complete the application process may consider themselves lucky. Insurance companies say that the data is still coming slowly, but even so they are being overburdened because of the frequent errors. The WSJ cited industry executives as saying that the enrollment data includes "duplicate enrollments, spouses reported as children, missing data fields and suspect eligibility determinations." One company also reported that some applications contained 3 spouses per application.

The insurance companies must clean up the enrollment data. This is usually a manual process and, in some cases, impossible to do conclusively without further information. For example, the enrollment records are not time-stamped when they arrive at the insurer, so if two applications differ in some detail, it is unclear which is the correct one. Blue Cross & Blue Shield of Nebraska has hired temps to contact enrollees for clarification. 

The WSJ states that the problems could do lasting damage to the law if customers are deterred from signing up or mistakenly believe that they have coverage when they do not.

A spokesperson for the Department of Health and Human Services, which administers the program, says that the system works and that they work aggressively to address problems as they come up. Executives at four health plans said that HHS had pressured them not to go public with their concerns about the data. 

From the WSJ:

Topics: Health, Government : US

About

Larry Seltzer has long been a recognized expert in technology, with a focus on mobile technology and security in recent years. He was most recently Editorial Director of BYTE, Dark Reading and Network Computing at UBM Tech. Prior to that he spent over a decade consulting and writing on technology subjects, primarily in the area of sec... Full Bio

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