#Obamacare Chronicles: So, you think you now have coverage, eh?

**Posted by Phineas

"Obamacare has arrived"
“Obamacare has arrived”

Let’s consider an all-too common occurrence in our Brave New World of affordable healthcare for all: You’re one of the many millions of individual insurance buyers who’s had his policy cancelled in the last few weeks, because of the Affordable Care Act and how the Democrats wrote the rules. You’re annoyed, but you sigh and realize you have to go to the Obamacare exchanges — you need the coverage, and it’s the “law of the land.” So, in spite of crashing web sites, higher premiums, bigger co-pays, outrageous deductibles, benefits you don’t need, and smaller provider networks, you finally find a policy you can live with. You grit your teeth, submit your application, and received a confirmation that, as of January 1st, 2014, you will still have health insurance.

Congratulations! You are an Obamacare success story!

Eh… Not so  fast, Doc:

Bob Shlora of Alpharetta, Ga., was supposed to be a belated Obamacare success story. After weeks of trying, the 61-year-old told ABC News he fully enrolled in a new health insurance plan through the federal marketplace over the weekend, and received a Humana policy ID number to prove it.

But two days later, his insurer has no record of the transaction, Shlora said, even though his account on the government website indicates that he has a plan.

“I feel like this: My application was taken … by a bureaucrat, it was put on a conveyor belt and it’s still going around, and it’s never going to leave the building,” he said. “I’ve lost hope. If it happens, great.”

Obama administration officials acknowledged today that some of the roughly 126,000 Americans (1) who completed the torturous online enrollment process in October and November might not be officially signed up with their selected issuer, even if the website has told them they are.

Oops! Must be one of those darned glitches. Curse that Republican obstructionism!

Mr. Shlora’s problem may have to do with what’s called an “834,” something used to convey all the necessary data to set up your account with the insurance company. These are transmitted every evening from by the government to the insurers. Trouble is, many of them are garbage:

Insurers report that, in some cases, 834s are coming in wrong. That’s a much more serious problem than the online traffic bottlenecks that have dominated coverage of the health-care law’s rollout.

If people can’t get into the Web site, then they simply have to come back later. But if they believe they’ve signed up for a plan but their 834 is a garbled mess — or, even worse, clear but wrong — it could mean chaos when they actually go to use their health insurance. For that reason, inside the health-care industry, the 834 problems are the glitch that is causing the most concern.

To back up a moment: 834 transmissions aren’t new. They have been around for decades as the standard form that employers use to tell their insurance companies which workers are on their health insurance plan each month.

An 834 transmission contains enrollment data like an individual’s social security number, their dependents and the plan that they picked. That data is, obviously, critical: If it comes in wrong, an applicant may not get the right plan, or family members may not be covered, or identity may not be verifiable.

In other words, like Mr. Shlora, you could wind up thinking you have coverage when you really don’t. That quote is from a Washington Post article dated October 23rd; Shlora signed up for his plan a full month later, yet was still left uncovered. Apparently those problems haven’t been fixed, in spite of Obama’s “tech surge.”

For the first few weeks after the Obamacare rollout, the insurance industry could handle these problems by fixing the 834s manually, since the web site’s traffic problems meant that only a few applications were getting through, anyway. But, with the front end getting closer to actually working (Most of the time. Kind of.) and with the deadline to apply and pay in order to be covered on January 1st fast approaching, a lot more people are going to be buying plans. Or so the government hopes. And all those people have to have their data sent by that same electronic system.

But ask yourself this: if these 834 problems still aren’t fixed, how many more people are going to buy coverage and then go to the doctor in 2014, only to be told the insurance company has no record of them? When you’re sick and need to see a doctor, the last thing you want to hear is “Wait a few days. A healthcare.gov specialist will get back to you.” The government claims 80% of the 834 problems have been fixed. So, 20% of the potentially hundreds of thousands of people signing up won’t have the coverage they thought they had — or any at all?

If the administration thinks they’re getting bad press now, just wait until that storm hits.

I’ll end with a good question from Mr. Shlora:

“The White House announced that they have met their goal,” he said of the much-touted improvements to the website. “They are taking applications but they aren’t going anywhere. What kind of goal is that?”

Under Obama, Bob, it’s good enough for government work.

RELATED: Speaking of the Obamacare site back-end and 834s, the administration refuses to share data on the error rate for transmissions to insurance companies. Anyone still think they have this problem fixed? Bueller? But, don’t worry: Obama is going to make a speech to reassure everyone that Obamacare is OK and everyone should remain calm.

(1) That’s 126,000 over two months, when the goal is seven million by the end of March. So, with 40% of the enrollment period past, the administration has hit 1.8% of its goal. And some people wonder why Democrats are panicking.

(Crossposted at Public Secrets)

Comments are closed.