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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

November 18, 2014 at 6:17 PM

Lawmakers voice anger with insurance exchange’s technical troubles

Updated Washington Healthplanfinder home page.

Updated Washington Healthplanfinder home page.

State lawmakers on Tuesday voiced their continued frustration with the technical problems still afflicting the Washington Healthplanfinder insurance exchange.

On Saturday, the first day of enrollment for the second round of insurance signups on the exchange, the site was live for only a couple of hours before a technical error was discovered and the exchange was taken offline for repairs. Meanwhile, first-round problems involving the transfer of payment information from the exchange to insurance companies have not been corrected, despite assurances they would be fixed by now.

“It’s very hard to understand why the IT system continues to fail,” Rep. Eileen Cody, D-Seattle, told officials from Washington Health Benefit Exchange, which runs the online insurance marketplace. “It’s just mind-boggling. With as much money as we have spent on this to not have it work is just not acceptable.”

After the initial shutdown, Healthplanfinder has been working since Sunday and approximately 25,000 people have completed applications for plans effective in 2015, exchange officials said Tuesday.

But some 1,500 people who used Healthplanfinder to buy insurance coverage for this year are still tangled up with payment problems, Richard Onizuka, chief executive officer of the exchange, told lawmakers at a hearing in Olympia before the Joint Select Committee on Health Care Oversight.

Because of errors in how the exchange system reports payment information to insurance companies, the insurers in some cases are incorrectly told a customer hasn’t paid his or her monthly insurance premium. Officials with the exchange had promised to fix the problem by Nov. 15, the day the new signups started. Onizuka said their new goal is to have it corrected by the end of the year.

There is also a problem with the exchange mailing incorrect invoices to approximately 4 to 6 percent of its customers. There are fixes under way to resolve that problem as well, Onizuka said.

The exchange sells insurance plans to people who do not have coverage through an employer or a government program such as Medicare. It’s also the place to enroll in Medicaid, the free health-care program that is called Apple Health in Washington state. The exchange is the only place for consumers to get insurance at a discounted price based on their income. Residents can also buy insurance outside of the exchange through brokers or directly from insurance companies.

After the first round of signups, approximately 140,000 residents have insurance from the exchange. The state hopes to enroll 85,000 new customers seeking coverage for 2015.

Of the 25,000 applications completed on the exchange so far in the first week of the second round, more than 10,000 are for insurance plans while the remainder are Medicaid applications. Officials don’t yet know how many are people renewing their coverage, as opposed to new customers. Roughly 2,000 of the applicants have scheduled their first payments.

Lawmakers asked Tuesday if people whose accounts were erroneously showing them as not having paid would be able to renew their accounts, and Onizuka assured the elected leaders the exchange has a system to allow them to do that.

Additionally, more than 500 small businesses have created accounts through the Healthplanfinder Business, which sells insurance to employers with 50 or fewer employees. The business exchange launched last month.

Washington, Vermont, Massachusetts and Rhode Island are the only states that opted to collect insurance payments from customers in the individual market and pass them to the insurance companies. Rhode Island is also having problems with their system, said Pam MacEwan, chief of staff for the exchange.

A Concord, Mass.-based company called Cambria Health is doing an independent review of the payment system and will explore the possibility of changing it so that customers pay the insurance companies directly. The board overseeing the exchange will consider the results next month and make a decision in February.

If the exchange does change its payment system, it wouldn’t go into effect until the signup period for 2016 insurance plans, MacEwan said.

The current signup period ends Feb. 15. People who want coverage that starts Jan. 1 must enroll and make their first payment by Dec. 23. Businesses can sign up for insurance year-round. Medicaid-eligible residents can also join the program at any time.

Comments | Topics: Richard Onizuka, Washington Health Benefit Exchange, Washington Healthplanfinder


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