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Wednesday, Feb 18 2015

Full Issue

Marketplace Website Still Has Many 'Back End' Glitches Affecting Insurers

Plans continue to have problems verifying whether consumers have enrolled and subsidy payments are not yet automated. Meanwhile, Democrats are preparing for blowback during tax season from people who realize for the first time that they will pay a penalty for failing to have insurance and some advocates call for a change to make it easier for pregnant women to sign up for coverage.

Behind the scenes, HealthCare.gov is still a mess. The back end of the Obamacare website still isnt properly wired to the health insurance companies. Its slow going for health plans to make sure the 11.4 million people who have signed up end up in the right plan. Subsidy payments arent automated, so the insurers get payments based on estimates. And adding information like a marriage or the birth of a child is a convoluted, multi-step process. ... Instead of a swift process, health plans use clunky workarounds and manual spreadsheets. It takes time and it costs money. (Pradhan and Norman, 2/17)

The Obamacare window technically just closed this weekend, but a new round of political headaches could just be beginning for the administration. That's because it's tax season, and many Americans could soon be getting an unwelcome surprise that they owe the government a penalty for skipping health insurance coverage. Up to 6 million Americans are expected to pay a penalty for not having coverage in 2014, according to recent Obama administration projections. (Millman, 2/17)

CMS officials have yet to say if the agency will implement an open-enrollment extension for people facing tax penalties who don't have coverage, an extension several states also are considering after Washington state enacted one. Some Congressional Democrats have been urging the Obama administration to implement a special-enrollment period for tax filers facing penalties. Sen. Tammy Baldwin (D-Wis.) and 10 other senators who caucus with the Democrats, on Monday sent a letter to HHS Secretary Sylvia Mathews Burwell calling for additional time to sign up for coverage. (Demko and Herman, 2/17)

The Obama administration often touts the health benefits women have gained under the Affordable Care Act, including the option to sign up for coverage outside of open enrollment periods if theyre "having a baby." But advocates complain the special insurance enrollment period begins only after a birth. As a result, uninsured women who learn they are pregnant outside of the regular three-month open enrollment period, which this year ended Sunday, can get stuck paying thousands of dollars for prenatal care and a delivery or worse, going without care. (Galewitz, 2/18)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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