Non-Existent Computer Program Leaves a Million Obamacare Enrollment Discrepancies to be Resolved by Hand

Sunday, May 18, 2014
(AP photo)

The enrollment issues with the Affordable Care Act, or Obamacare, are fixed, but the federal government’s computer experts aren’t finished yet. More than a million Americans may be getting incorrect subsidies for their health plans. And since the federal government hasn’t yet created the proper computer program to address the problem, it will have to resolve each of those cases by hand.


When an applicant applies for premium subsidies, they enter their income. Later, that figure is matched with data from the Internal Revenue Service for verification. If the figures are too far off, the now-insured person must provide supporting data to the government, which many people have done.


Right now, the big problem for the federal government is that there’s no way to connect that supporting data to the insured’s account because the computer capability to do that has not been built, according to The Washington Post.


Other problems exist with verification of citizenship status. Flaws at blocked many people who are naturalized citizens or permanent legal residents from purchasing insurance. In addition, many applicants who were put into incorrect income categories during registration haven’t been able to correct the error.


“[T]here is no indication that infrastructure ... necessary for conducting informal reviews and fair hearings has even been created, let alone become operational,” attorneys at the National Health Law Program said in a letter sent late last year to officials of the Centers for Medicare and Medicaid Services (CMS), which oversees


For now, problems such as questions of citizenship and other appeals will be addressed by hand, given the lack of computer support. Officials also recommend applicants start the process over, now that the rest of the health care system is functioning better. The work of verifying income won’t begin until this summer.


Those whose subsidies might have been calculated incorrectly will continue to get their current premium support. If it’s found later that they’ve been overpaid, they will have to refund the money to the government. “I have this sick feeling that there are these people out there who have made unintentional errors, and in a few years will be subject to massive tax bills,” said Jessica Waltman, senior vice president for government affairs at the National Association of Health Underwriters, a lobbying group for health insurance brokers.


In the hopes of solving these problems, President Barack Obama has assigned a top staff member to deal with rollout issues. On Friday, Obama appointed longtime aide Kristie Canegallo as deputy chief of staff for policy implementation. Canegallo, who formerly worked for the National Security Council, will also be in charge of data privacy issues and withdrawal of troops from Afghanistan.

-Steve Straehley


To Learn More:

Federal Health-Care Subsidies May Be Too High Or Too Low For More Than 1 Million Americans (by Amy Goldstein and Sandhya Somashekhar, Washington Post) Can’t Handle Appeals Of Enrollment Errors (by Amy Goldstein, Washington Post)

White House Aide Named By Obama To Oversee Health-Care Law, Other Priorities (by Juliet Eilperin, Washington Post)

If Medicare Rollout was Smoother in 1966, Why was Affordable Care a Mess in 2013? (Hint: Insurance Companies) (by Matt Bewig, AllGov)

Healthcare Site Problems Prevent Thousands of Medicaid Sign-Ups (by Noel Brinkerhoff, AllGov)


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