HealthCare.gov Data Still Unreliable

Reports from insurance companies indicate one in five people who signed up for health insurance under the new health care law failed to pay their premiums on time and therefore, did not receive coverage in January.

Paying the first month’s premium is the final step in completing enrollment. Under federal rules, people must pay the initial premium for coverage to take effect. In view of the chaotic debut of the federal marketplace and many state exchanges, the White House urged insurers to give people more time, and many agreed to do so. But, insurers said, some people missed even the extended deadlines.

  • Blue Shield of California said that 20 percent of those who signed up for the new health care law failed to pay their premiums.
  • Aetna said that about 30 percent of those who signed up for the new health care law failed to pay their premiums.
  • WellPoint said that 24 percent of those who signed up for the new health care law failed to pay their premiums. The company offers individual coverage through the exchanges in 14 states.
  • Humana said that 25 percent of those who signed up for the new health care law failed to pay their premiums.
  • Health Care Service Corporation, which offers Blue Cross and Blue Shield plans in Illinois, Texas and three other states, said that around 20 percent of those who signed up for the new health care law failed to pay their premiums.

Break Away from the Static

There are many reasons why this happens.  People are enrolling in multiple places, then they never get back on HealthCare.gov to dis-enroll from plans they enrolled in previously. Some decided they did not want a health plan for which they had applied.

Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, which runs the federal exchange and supervises state marketplaces, admitted that the government did not know how many people had paid their premiums and thus “effectuated” coverage. But in interviews and in the quarterly reports on their financial performance, insurers provided data indicating that one in five people who signed up for health insurance under the new health care law failed to meet payment deadlines.

Obama administration officials said they did not know how many people signing up for coverage had paid their premiums because the government had not finished building the “back end” of the computer systems needed to pay insurers.

As always, ADVOCATE will keep you updated on this and all issues impacting radiology as they become available.

Best regards,
Kirk Reinitz, CPA
President/CEO