Does The Obama Administration Already Know How Many Obamacare Sign-Ups Paid?

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Representatives from several top insurance companies hinted at a House subcommittee hearing Wednesday that the Obama administration may know more than they’re letting on about how many Obamacare sign-ups have paid for their plans.

Ohio Republican Rep. Bill Johnson pressed a panel of insurance industry executives on how the federal government is currently paying insurers Obamacare subsidies if they’re not sure how many active Obamacare customers there are. The hearing held by an oversight subcommittee of the House Energy and Commerce committee featured questions from Republicans on how many Obamacare sign-ups have paid.

“So how do you get paid?”Johnson asked. “How do you get paid and what is that based on? What information do you provide the government, the administration that gets you paid?” 

Aetna official Paul Wingle replied that the communication of enrollment files between the federal government and insurers ensured that insurers would be paid premium subsidies for eligible Obamacare customers — but Wingle clarified that subsidies are received only for “effectuated” enrollments whose premiums have been paid.

“So if you only submit for effectuated — doesn’t the administration know the pay rate?” Johnson pressed.

“So today the payments that are coming back and forth are estimated so there’s not been a direct reconciliation between our company and the exchange on a member-by-member basis,” Wingle clarified. “That’s one of the works in progress we discussed on the back-end discussion.”

The insurance officials all reported that the Obama administration’s failure to finish building the back-end of prevented the administration from automatically gathering information on who’s paid, and all denied knowledge of whether the Obama administration knows details about payment rates. The portion of that is supposed to communicate enrollment, subsidy and payment information between insurers and the federal government has not yet been built, seven months after its due date.

While it’s still now clear how many customers have actually paid their premiums, Aetna’s response indicates that the Obama administration likely knows more than its letting on.

According to Health and Human Services’ final enrollment report encompassing the entire period, 85 percent of sign-ups were eligible for Obamacare subsidies. Given that insurers have been to the Obama administration the amount of premium subsidies they’re due for this group for months, administration officials have at the very least some knowledge of how many people are paying for their coverage, despite their insistence that no information is available.

Cigna official Brian Evanko testified that the company has received $30 million to $40 million in premium subsidies so far this year. No other officials were prepared to say how much their companies have already received.

The insurers present, as well as all 160 insurers participating in the federal exchange, will provide updates to payment information already provided to the committee by May 20. 

The first information provided by anyone in the federal government came last week from a Energy and Commerce committee report, which found that 67 percent of sign-ups in federal exchanges had paid by April 15, noting that many sign-ups had several weeks before a final payment deadline and promising to issue an updated report in one month. (RELATED: Report: Just 2.4 Million Customers Paid Their First Premium)

Democratic committee members lambasted their Republican counterparts Wednesday for releasing the payment information.

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