Insurers Claim Health Website Is Still Flawed

The problem is that so-called back end systems, which are supposed to deliver consumer information to insurers, still have not been fixed. And with coverage for many people scheduled to begin in just 30 days, insurers are worried the repairs may not be completed in time.

“Until the enrollment process is working from end to end, many consumers will not be able to enroll in coverage,” said Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group.

The issues are vexing and complex. Some insurers say they have been deluged with phone calls from people who believe they have signed up for a particular health plan, only to find that the company has no record of the enrollment. Others say information they received about new enrollees was inaccurate or incomplete, so they had to track down additional data — a laborious task that would not be feasible if data is missing for tens of thousands of consumers.

In still other cases, insurers said, they have not been told how much of a customer’s premium will be subsidized by the government, so they do not know how much to charge the policyholder.

In trying to fix HealthCare.gov, President Obama has given top priority to the needs of consumers, assuming that arrangements with insurers could be worked out later.

The White House announced on Sunday that it had met its goal for improving HealthCare.gov so the website “will work smoothly for the vast majority of users.”

In effect, the administration gave itself a passing grade. Because of hundreds of software fixes and hardware upgrades in the last month, it said, the website — the main channel for people to buy insurance under the 2010 health care law — is now working more than 90 percent of the time, up from 40 percent during some weeks in October.

Jeffrey D. Zients, the presidential adviser leading the repair effort, said he had shaken up management of the website so the team was now “working with the velocity and discipline of a high-performing private sector company.”

Mr. Zients said 50,000 people could use the website at the same time and that the error rate, reflecting the failure of web pages to load properly, was consistently less than 1 percent, down from 6 percent before the overhaul.

Pages on the site generally load faster, in less than a second, compared with an average of eight seconds in late October, Mr. Zients said.

Whether Mr. Obama can fix his job approval ratings as well as the website is unclear. Public opinion polls suggest he may have done more political damage to himself in the last two months than Republican attacks on the health care law did in three years.

People who have tried to use the website in the last few days report a mixed experience, with some definitely noticing improvements.

“Every week, it’s been getting better,” said Lynne M. Thorp, who leads a team of counselors, or navigators, in southwestern Florida. “It’s getting faster, and nobody’s getting kicked out.”

But neither Mr. Zients nor the Department of Health and Human Services indicated how many people were completing all the steps required to enroll in a health plan through the federal site, which serves residents of 36 states.

And unless enrollments are completed correctly, coverage may be in doubt.

For insurers the process is maddeningly inconsistent. Some people clearly are being enrolled. But insurers say they are still getting duplicate files and, more worrisome, sometimes not receiving information on every enrollment taking place.

“Health plans can’t process enrollments they don’t receive,” said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans.

Despite talk from time to time of finding some sort of workaround, experts say insurers have little choice but to wait for the government to fix these problems. The insurers are in “an unenviable position,” said Brett Graham, a managing director at Leavitt Partners, which has been advising states and others on the exchanges. “Although they don’t have the responsibility or the capability to fix the system, they’re reliant on it.”

Jess Bidgood, Dan Frosch and Jennifer Preston contributed reporting.

Article source: http://www.nytimes.com/2013/12/02/business/white-house-praises-gains-on-health-site.html?partner=rss&emc=rss