Guy Benson


Getting covered requires paying your first month of premiums. And paying those premiums entails your insurer having a record of who you are -- which is no slam dunk, given the exchanges' technical travails. CNN Money has a story today describing the compressed time frame for getting insured -- not "selecting a plan" or applying, but actually gaining coverage -- by Jan 1, 2014. The piece includes a few significant revelations, including a glimpse at one insurer's payment follow-through statistics thus far. Not good:


Just because you've picked an Obamacare insurance policy doesn't mean you've got coverage. If you want to be insured come Jan. 1, you have to pay your first month's premium by your insurer's due date, often Dec. 31. The tight deadline and continuing errors with consumers' applications being sent to insurers also risk leaving some folks uncovered. Obama administration officials are advising consumers to check with their insurer of choice to make sure it received their application and payment and that coverage will begin Jan. 1...While the Obama administration has reported that more than 100,000 Americans picked plans in October, the first month of open enrollment, it's not known how many of them have paid. One insurer, Physicians Health Plan of Northern Indiana, has received payments from only about 20% of applicants, nearly all using the firm's online portal, said Jim Brunnemer, the chief financial officer. It is sending invoices and email reminders to those who haven't yet sealed the deal. If payment isn't made by New Year's Eve, PHP has been told by federal officials that it must void the application. Another complication is that insurers also don't have a lot of time to process applications and send out ID cards. The timeline, particularly over the holiday week, will prove "challenging" for some companies, one industry executive said.


Physicians Health Plan is just one isolated example, to be sure, but it's all we've got to work with at the moment. Kathleen Sebelius has refused to say what percentage of the administration's "enrollment" pool has completed the process by paying the first month of premiums. If this Indiana insurer's experience is even remotely similar to industry averages, come January, there will be a lot of uncovered people who think they're insured walking around. What happens when those people get into accidents, schedule doctor's appointments, or experience a health emergency. Another important detail in CNN's piece is that if these people haven't paid up by December 31, their original enrollments will be vitiated. This will require them to start the process over in order to gain the coverage they thought they already had. Others won't be insured because of the exchanges' back-end fiasco, which continues to cast a foreboding shadow over the entire operation. Our historically transparent administration adamantly declines to comment on various error rates, although a recent Washington Post story suggested that bugs may have impacted one out of every three enrollments. Because Obamacare officials won't tell the public what's happening behind the scenes, consumers must rely on accounts from insiders like expert Bob Laszewski, who speaks with insurers on a daily basis. Here he is on Fox News last night talking about the "disaster" that awaits the exchanges' back end. Stick with this clip through the end, when he explains that so-called 834 transaction error rates haven't improved at all since Healthcare.gov's checkered November 30 re-launch:



"They fixed the front end of the website because it was a political embarrassment to them. The back end of the website is a disaster. They can't pay the insurance companies. They haven't built the system to transfer the federal subsidies to the insurance companies yet. They can't do a reconciliation via the computer because they haven't built the reconciliation system to figure out if the people the government thinks are covered are covered on the insurance company's site...enrollments that came through on Monday have just as high an error rate as enrollments did three weeks ago."


The government is trying to mitigate this problem with on-the-fly overpayments to insurers that can be reconciled down the line. Meanwhile, one of the Obamacare "successes" the administration likes to crow about is the number of Americans who've signed up for Medicaid via the new law's expansion of the existing entitlement program. As I've pointed out countless times, many more people joining the Medicaid rolls isn't good news at all. A disproportionate number of Medicaid sign ups not only threatens the entire Obamacare financial structure -- and by extension, the US healthcare market -- it funnels more people into a terribly broken program that is already underfunded and has been demonstrated to be an empirical failure. But even if you buy into the Left's narrative that pushing a bunch of people into Medicaid is terrific, it turns out that Healthcare.gov's failures have disrupted that process, too:


States are warning that they may not process Medicaid enrollments from people who have signed up for the health program through the troubled HealthCare.gov site, raising the prospect that several hundred thousand low-income people who thought they had obtained insurance actually may not have it. The federal health-insurance site, which serves residents in 36 states, is designed to sell policies from private insurers. But some people who apply for coverage through the site discover they are eligible instead for Medicaid, the joint federal-state health-insurance program for the poor and disabled. So far, the federal government has been unable to transfer full Medicaid applications to states, potentially leaving people who sought to sign up for Medicaid through HealthCare.gov without coverage.


They've been unable to transfer any Medicaid applications to the states? Honestly, what haven't they screwed up?


Guy Benson

Guy Benson is Townhall.com's Senior Political Editor. Follow him on Twitter @guypbenson.

Author Photo credit: Jensen Sutta Photography