ObamaCare Progress Report Week 10: Fixed Glitches and New Workarounds

Healthcare.gov took a big step forward this week after a re-tooled healthcare.gov is now able to handle more users.

The Obama Administration’s self-imposed deadline of Nov. 30 to remove the massive glitches on the federal exchange brought more functionality to the site, and the Department of Health and Human Services reports the site can now handle up to 50,000 users at a time and 800,000 users daily.

With just over two weeks left until the Dec. 23 deadline for consumers to enroll in a plan to have coverage on Jan. 1, Manhattan Institute scholar Yevgeniy Feyman says exchange performance is more crucial now than ever before.

As of Nov.15, HHS reported 106,185 individuals had enrolled in coverage, including people who may not have yet paid their monthly premiums. The insurance industry typically considers a person enrolled once they pay the premium. The White House has said it hopes to have seven million people in enrolled in year one of the ACA, with 2.7 million of them being young and healthy people needed to keep premium costs down.

Under the ACA, every individual must have insurance by the end of open enrollment period on April 1, 2014, or they will face a penalty of $95 a year of 1% of their annual income.

“The site can handle up to 50,000 users a day, which is decent,” Feyman says. “It’s way better than before, and inside sources at the White House are saying enrollment is spiking. But after Jan. 1, that is crunch time and when everything needs to really continue working. This is a moving target.”

The week also exposed a major flaw in the federal exchange: the lack of a payment mechanism for insurance companies to receive funds from the government to cover subsidized and cost-shared plans. This means insurance companies will have to bill the government in order to receive these payments, and consumers have the potential to be squeezed in the middle. 

Larry Kocot, Brookings Institution visiting fellow, says he is concerned about this back-end issue, and the ability of an insurer to determine if an individual is insured come Jan.1.

“How will they determine if their subsidy is correct?” he says. “This has a huge bearing on how a person will use this and how they will be covered.”

Friday afternoon, a government spokesperson confirmed that one out 10 transaction forms to the private insurance companies from healthcare.gov have errors.

Feyman says the 834 forms are crucial to insurers’ ability to write policies.

“The 10% error rate has to do with demographic information on family size, age and more in these forms that insurers need to properly write a policy,” he says. “With incorrect information, insurers don’t know who’s getting what policy and how much they need to pay.”