By the end of 2013, roughly two million Americans had enrolled in insurance plans via the state and federal insurance exchanges created under the auspices of the Affordable Care Act. While that number was significantly below the 3.3 million administration officials had set as a year-end target, it was regarded as proof that enrollment trends had gained momentum after the early December relaunch of the federal healthcare website — where, for weeks, numerous design flaws and software errors had caused hours-long wait times and prevented potential customers from creating accounts and completing the 30-step enrollment process. The 2-million enrollment figure — a small portion of the 6 to 7 million total enrollments expected by the administration — was a sign that the website’s technical problems had not completely derailed the health care reform.
But with the policies of millions of Americans cancelled for not offering all the required Obamacare benefits and millions of uninsured Americans yet to sign up, there is much progress left to make before the reform can be deemed a success. Essential to that goal is for those Americans who have purchased insurance through exchanges to find the policies to be affordable and the coverage to be good. But before that happens, other enrollment issues must be sorted out. Thanks to the glitch-riddled weeks of exchange operation following the system’s October 1 launch, some individuals have signed up for healthcare coverage multiple times, while many others are beginning to discover that their insurance applications fell through the cracks and insurers have no record of their policies. As a result, consumers are redirecting their health care critiques away from the troubled federal website, Healthcare.gov, and toward the insurance industry.
Many new policyholders are finding that their insurance provider cannot confirm coverage intended to take effect on January 1, will not answer basic questions, and have not issued the identification numbers needed to fill prescriptions or access medical care, according to a report in the Los Angeles Times. Without proof of insurance, patients must pay out of pocket, if they can afford it, for doctor visits and medications. Most affected are those insurance policyholders with chronic illnesses, cancer, or who are pregnant.
In general, this issue is not a function of any failure to make the first month’s premium payment. Rather, insurers say that the poor functioning of the federal healthcare website — which prevented many potential insurance customers from signing up in October and November and prompted the administration to extend enrollment deadlines for January 1 coverage — created a bottleneck of applications in late December. The wave of policy cancellations have only added to the backlog.
For now, criticism from healthcare customers is directed at the insurance industry. But because Obamacare exchange enrollment has been dominated by problem after problem, this latest issue with coverage confirmation may further sour public opinion on the healthcare reform. According to Boston University health-policy professor Alan Sager, the inability of insurance providers to confirm coverage for a significant number enrollees is another hurdle for the Affordable Care to overcome after the problems with Healthcare.gov. “There’s equal opportunity for incompetence by the public and private sector in administering such a large new program,” he told the Times. “People are deservedly angry and resentful.”
Outrage has been so great that insurance companies have begun to apologize. San Francisco-based Blue Shield posted this message on its Facebook page on January 7. “We’re very sorry for any issues you’re experiencing when reaching out to our customer service center or visiting our website. It is every bit as unacceptable to us as it is to you. While we anticipated and planned for increased traffic, the sheer volume of enrollments has swamped all major health plans. We owe you a much better service experience and are working through this challenge as quickly as we can. Thanks for being patient.”
WellPoint (NYSE:WLP), which is sells insurance policies in 14 states, responded to more 1 million customer calls during just two days last week, a call volume equal to a normal month’s average. The recent changes to Obamacare implementation and the law’s shifting deadlines “are impacting the timeline for us to process customer applications, issue billing statements, process payment and issue coverage ID cards,” WellPoint spokesperson Kristin Binns said in a statement obtained by the publication. “We greatly appreciate patience during this transitional time and apologize for any inconvenience they may have experienced.”
“Health plans have gone above and beyond to protect consumers from disruptions caused by the ongoing problems with Healthcare.gov” and some state exchanges, Robert Zirkelbach, a spokesperson for the industry group America’s Health Insurance Plans, told the Times. “The last-minute changes to deadlines and rules have made the process more complicated and time-consuming,” he added, echoing the sentiments expressed by Binns.
However, many customers believe these insurance companies had enough time to prepare for the onslaught of new insurance customers. “They knew it was coming,” said public-health consultant Katherine Kokko, who explained her difficulties receiving confirmation coverage to the publication. Kokko, 34, signed up for her Anthem Blue Cross Blue Shield policy on December 20, well ahead of the deadline for coverage beginning January 1, and soon after paid her $325 monthly premium. After spending 10 hours on hold with her insurer this week, she was informed she did not have an insurance identification number, meaning she did not have the proof of insurance needed for Anthem to authorize the physical therapy Kokko needed following a December knee surgery.
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