Insurance Companies Struggle With ‘Duplicate Enrollments’ Left By Chaos

Patrick Howley Political Reporter
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“Duplicate enrollments” caused by the glitch-ridden rollout of HealthCare.Gov are complicating insurance companies’ ability to determine how many people have paid their Obamacare premiums, according to prepared congressional testimony obtained by The Daily Caller.

“Because of the challenges that surfaced with the launch of the Exchanges in October 2013, some consumers were advised to create a new account and enroll again. As a result, insurers have many duplicate enrollments in their system for which they never received any payment,” said Mark Pratt, senior vice president for state affairs at America’s Health Insurance Plans, a national association representing health insurance plans. Pratt made the statement in testimony submitted to the House Energy and Commerce Committee’s subcommittee on oversight and investigations ahead of a Wednesday morning hearing on Obamacare’s impact on the insurance industry.

“In cases where an insurer has a new enrollment for a consumer who previously enrolled, they are not expecting that original policy to be effectuated – even though that data is still reported,” Pratt testified.

“On a broad range of issues, our members have provided technical assistance and expertise to assist federal agencies in resolving the operational challenges that surrounded the launch of the new Exchanges and the website. They also have devoted significant resources to performing manual processes and work-arounds that were necessitated by the problems that surfaced in the days and weeks following the October 1 launch. Under ever-changing deadlines and operational guidance, they processed enrollment files and payments in short timeframes,” Pratt said.

Pratt also identified other factors — including an Obama administration rule change giving enrollees more time to pay their premiums as a result of the disastrous launch — that “contribute to the uncertainty about how many Exchange enrollees have paid their premiums.”

“One reason there is uncertainty about the number of Exchange enrollees who have paid their premiums is that some insurers – to provide peace of mind for consumers and to protect them from potential gaps in coverage – have voluntarily decided to provide flexibility in the deadline by which Exchange enrollees must pay their first month’s premium. This flexibility is allowed under an interim final rule published by HHS on December 17, 2013,” Pratt said.

“In early February, CMS implemented the functionality for Exchange enrollees to voluntarily terminate their plan or to report a ‘life event’ (i.e., a change in circumstance, such as a new baby or job, which allows a special enrollment period). While this functionality serves a valid purpose, it creates challenges in calculating accurate enrollment data and payment rates,” Pratt said.

“In the coming weeks, as we move further past the conclusion of the open enrollment period for 2014, we anticipate that there will be greater clarity on the question of how many Exchange enrollees have paid their premiums. A number of individual plans have publicly announced their data, and we anticipate that more announcements will be forthcoming. However, given the significant variation in enrollment that occurs in the individual marketplace, it may be a matter of months before system-wide numbers on premium payments are available,” Pratt testified.

Pratt also called for the repeal of Obamacare’s health insurance tax, which he said is “undermining efforts to control costs and provide affordable coverage options.”

Pratt also noted that “We remain concerned that adverse selection and unnecessarily high costs will occur in the absence of broad participation in the new Exchanges.”

An Aetna executive testified before the subcommittee that “roughly” 500,000 out of 600,000 enrollees had paid their premiums by the third week of April. An executive for a nonprofit health insurance company that does business as Blue Cross and Blue Shield in several states was also forced to provide a mere estimate, stating that approximately 83 percent of customers on Obamacare exchange plans had paid their premiums by April 1, based on a “good faith estimate.”

“At the current time enrollment and payment information (both on and off the exchanges) can only be presented as of each day when the numbers are counted,” the executive stated.

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