Insurers among those confused by federal health care exchange - The Buffalo News

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Insurers among those confused by federal health care exchange

WASHINGTON – The federal health-care exchange that opened 12 days ago is marred by snags beyond the widely publicized computer gridlock that has thwarted Americans trying to buy a health plan. Even when consumers have been able to sign up, insurers sometimes can’t tell who their new customers are because of a separate set of computer defects.

The problems stem from a feature of the online marketplace’s computer system that is designed to send each insurer a daily report listing people who have just enrolled. According to several insurance industry officials, the reports are sometimes confusing and duplicative. In some cases, they show – correctly or not – that the same person enrolled and canceled several times on a single day.

The ability of consumers to sign up for a health plan, and the ability of the insurers to know who they are covering, is key to the success of the federal law that will for the first time require most Americans to buy health insurance starting Jan. 1. The site is the main path for millions of Americans in 36 states to purchase new coverage.

The flawed enrollment reports illustrate that the website is bedeviled by problems that go beyond what the Obama administration has acknowledged in explaining the creaky performance of the exchange so far.

At the White House and the Department of Health and Human Services, officials have portrayed the exchange as a victim of its own popularity, with a larger-than-expected crush of Americans rushing to a website that wasn’t built to accommodate so many people at once.

That explanation puts the focus up front – on the servers and software that help consumers take the first step of registering for an account. Evidence is emerging from the insurance industry and elsewhere, however, that the exchange also has flaws that show up further along in the process – as consumers try to check whether they qualify for federal subsidies and as insurers try to find out who has enrolled.

For instance, one major insurance carrier, Cigna, sent a notice Wednesday to insurance brokers instructing them to wait until November to try to sign up customers who might qualify for a subsidy, according to Joseph Mondy, a Cigna spokesman. He said that the company does not yet trust the reliability of the part of the exchange that is supposed to calculate the tax credits that will, for the first time, help some Americans pay for private health coverage.

Insurers are uncertain of the cause of the flaws, with some speculating that the exchange cannot consolidate consumers’ moves through the website as they shop for and ultimately choose a health plan. Others say the problem could be unrelated software errors.

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