Health insurers getting bad data from healthcare.gov

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.

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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

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7 comments
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  • Sounds like a typical software release to me

    The proof in the pudding will be whether they have a decent bug triaging process.
    krisoccer
  • Testing? We Don't Need No Stinking Testing!

    Don't you know?
    It just works like HHS says!

    /s
    rhonin
  • Possibility of deliberate fraud

    Not mentioned here is the possibility of bad actors trying to enter bad data deliberately, in hopes of manufacturing a scandal, or attempting actual fraud -- something for which we as yet have no numbers. There is enough political bad feeling against the ACA to make the former a possibility, and the latter cannot be dismissed. Winnowing out the good applications from the bad, the false, the deliberately fabricated in a timely fashion will be a real test.
    progan019
    • I doubt that. Too much work for too little return.

      besides, it would take A LOT of bad actors to do that, so not much worry there.

      The facts all point to one conclusion - a system built on 10 year old technology that originally was quoted for 90 million that ballooned into 290 million, from a company that had a few contracts voided do to concerns like these?

      That tells me that it's not the work of bad actors, just bad programmers.
      William.Farrel
      • 'built on 10 year old technology'

        lots of google hits on that phrase... didn't see anything about who said it, when or why...

        attempting to follow Heinlein's advice to 'get the facts!' resulted in: 'not much.'

        anyone got a link?
        BitBanger_USA
  • Data quality

    Data 'what'?!
    Rabid Howler Monkey
  • User error?

    Those of us who have been in the IT service field are quite aware of just how prevalent user error can be. This is not meant as any kind of slam on those who have tried to use the website. It is far too common for the casual user to not understand a web form and make an eroneous entry or even duplicate ones.

    It's not like WSJ has no ajenda either.
    harrim47