About 10 Percent of Obamacare Enrollment Files Have Errors

HHS has struggled to figure out the extent of HealthCare.gov’s back-end problems

A woman looks at the HealthCare.gov insurance exchange internet site October 1, 2013 in Washington, DC. US President Barack Obama's Affordable Care Act, or Obamacare as it is commonly called, passed in March 2010, went into effect Tuesday at 8am EST. Heavy Internet traffic and system problems plagued the launch of the new health insurance exchanges Tuesday morning. Consumers attempting to log on were met with an error message early Tuesday due to an overload of Internet traffic. AFP PHOTO / Karen BLEIER 
National Journal
Sam Baker
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Sam Baker
Dec. 6, 2013, 12:14 p.m.

The Obama ad­min­is­tra­tion says it’s mak­ing pro­gress on back-end is­sues with Health­Care.gov, but it has only re­cently got­ten a handle on how bad those is­sues are.

The Cen­ters for Medi­care and Medi­caid Ser­vices has clearly made a lot of pro­gress tack­ling the most vis­ible, and thus the most em­bar­rass­ing, prob­lems with the en­roll­ment web­site. But CMS has been slower about fix­ing the back end — er­rors in the in­form­a­tion the site sends to in­sur­ance com­pan­ies.

In Oc­to­ber and Novem­ber, up to 25 per­cent of en­roll­ments had some sort of er­ror, CMS Com­mu­nic­a­tions Dir­ect­or Ju­lie Ba­taille said Fri­day. She said CMS be­lieves the er­ror rate is now down to about 10 per­cent, but she stressed that the es­tim­ate is pre­lim­in­ary, be­cause the agency has had a hard time even know­ing wheth­er it’s catch­ing all the er­rors that are hap­pen­ing.

In­surers have com­plained since the site’s Oct. 1 launch that they couldn’t pro­cess a lot of the in­form­a­tion they were get­ting from Health­Care.gov. They wer­en’t sure who had ac­tu­ally en­rolled, or they got in­ac­cur­ate or in­com­plete in­form­a­tion about those people. These er­rors could have ma­jor real-world im­plic­a­tions if, for ex­ample, people think they’re covered but their en­roll­ment didn’t ac­tu­ally go through to an in­sur­ance com­pany.

Ba­taille said there have been three main types of er­rors with the “834” trans­mis­sions to in­surers: 834 forms that were not sub­mit­ted at all; du­plic­ates; and trans­mis­sions that were sub­mit­ted but con­tained er­rors.

Get­ting a handle on the er­ror rate has been dif­fi­cult be­cause it’s hard to know how many 834s are simply miss­ing, and not all er­rors are ap­par­ent as er­rors.

Al­though the Obama ad­min­is­tra­tion got the site’s user ex­per­i­ence fixed be­fore its back-end prob­lems, Ba­taille said CMS and its lead con­tract­or for Health­Care.gov re­pairs, QSSI, now have a ded­ic­ated team in place for these is­sues.

“We are do­ing this work in­tensely now,” she said.

In­surers were able to sort through 834 is­sues by hand in Oc­to­ber and Novem­ber, when only a trickle of people could ac­tu­ally make it through the site to en­roll. They feared dur­ing that time that the White House would fix the site’s polit­ic­ally em­bar­rass­ing front end first, flood­ing them with more bad in­form­a­tion than they could handle.

In­surers say the pro­cess is get­ting bet­ter, but that they’re still see­ing er­rors.

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