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‘Back End’ Of Obama-Care Has Still Not Been Built

From Fox News:

Forget Enrollment, There’s Another Major Piece Missing from ObamaCare

By Kate Rogers | March 25, 2014

Much emphasis has been placed on enrollment stats as the Affordable Care Act’s inaugural open enrollment period comes to an end. But there’s a key function on the federal exchange that remains inactive: the mechanism to reconcile payments between the government and insurance companies.

This “back-end mechanism” has been missing for the entirety of open enrollment period, which launched Oct.1, meaning insurance companies have had to manually bill the government for subsidies and cost-sharing plans, a procedure that’s being dubbed an administrative nightmare.

An insurance industry source close to the matter says insurance companies have been participating in a manual workaround over the last five months, which has been “an incredibly labor intensive process.” …

CMS continues to work on the back-end system, although it is not yet clear when it will be up and running…

Bob Laszewski, author of the Health Care Marketplace and Policy Blog, says the missing payment mechanism is contributing to the lack of clarity over enrollment numbers.

“The carriers can’t automate reconciliation, and don’t have a billing system—everything is done manually and the carriers are in a bigger and bigger mess,” he explains. “This will be enormously complicated once its fixed. The administrative headache is just incredible.”

Enrollees have to stay on the enrollment roll for 90 days, even if they don’t pay, Laszewski says, and the “non-payment” also includes individuals who have potentially paid their portion of the plan, but are waiting on the government to complete payment in regard to subsidies…

Laszewski was among the first to report that nearly 20% of enrollees had not yet paid their first month’s premiums.

If a new system is not in place by November’s open enrollment period for 2015, Laszewski says insurance companies won’t be pleased.

“I think most carriers would pull out of the program,” Laszewski says. “Everyone believes this will be up and running in a month or two. If not, we will have an administrative nightmare. If I were an executive in a program, I would pull out—you can’t run your business. You don’t know what the premium is, who you are covering. I can’t imagine any carriers staying in the program, but I do think it will be fixed, so I hope we won’t be in that situation.”

It sounds like a typical government program to us.

But in any case, guess who will pay for all of this confusion? Anyone with an insurance premium. Oh, and the taxpayers who are subsidizing Obama’s base.

This article was posted by Steve Gilbert on Wednesday, March 26th, 2014. Comments are currently closed.

One Response to “‘Back End’ Of Obama-Care Has Still Not Been Built”

  1. Henry David Thoreau, Civil Disobedience and Other Essays

    “If the machine of government is of such a nature that it requires you to be the agent of injustice to another, then, I say, break the law”

    “Unjust laws exist; shall we be content to obey them, or shall we endeavor to amend them, and obey them until we have succeeded, or shall we transgress them at once? Men generally, under such a government as this, think that they ought to wait until they have persuaded the majority to alter them. They think that, if they should resist, the remedy would be worse than the evil. But it is the fault of the government itself that the remedy is worse than the evil. It makes it worse. Why is it not more apt to anticipate and provide for reform? Why does it not cherish its wise minority? Why does it cry and resist before it is hurt? Why does it not encourage its citizens to be on the alert to point out its faults, and do better than it would have them?”


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