As we go through the fifth week of the Obamacare rollout, not much has changed in the health insurance marketplace sphere. Although healthcare.gov has not substantially improved, minor improvements have trickled in. Enrollments are picking up, but the numbers are still nothing to boast about, especially when compared to the projected numbers given before the marketplaces went live. So, what are the challenges being faced by the administration and healthcare industry, and what are the action points for the government to iron out these challenges? Let’s find out.
Top Challenges for Week #5
• Enrollments are nothing more than a slow trickle – the Obama administration had set a target of nearly 7 million enrollments. For health plans with large market shares, a comparable contribution to the target should be 100,000 to 200,000 enrollments. However, the actual numbers are dismal, to say the least. Across the country, top health plans have averaged around 100 to 200 enrollments in the first 35 days of the launch.
• People want to signup, but they can’t – A slow trickle of enrollments might seem to indicate that people don’t want to sign-up, but it actually isn’t the case. People are looking forward to enrolling, with or without exchanges, and healthcare.gov is serving as a major deterrent in the task. Whether Obamacare will meet its target of 7 million enrollments or not, the inability to enroll is going to mar the performance.
• Paper applications might look like the saviors, but they actually aren’t – With healthcare.gov being in a complete state of flux, people are looking toward paper applications for enrolling. While this might seem a practical, albeit cumbersome, alternative, it is not working properly either. Thousands of paper applications have been filed, but the system has not received more than a few hundred. So where are these remaining paper applications? No one seems to know. On the other hand, people who have been issued a renewal notice are enrolling through their health plan’s private exchange. Through early renewal discounts, these health plans have been able to sell insurance plans that will be valid until December 31, 2014, and prevent people from going through a painful enrollment process.
• Lack of online support means a cumbersome, difficult to understand procedure – understanding the whole gamut of offerings from different insurance providers in your region on a computer is one thing, and getting that same information on phone is different. The latter is a lot more time consuming, confusing and difficult to gather. Even the exchange navigators are at a loss on utilizing the full capabilities of the site as healthcare.gov continues not to function properly.
• The 834 problem – The 834 problem is a new challenge that has cropped up in the last couple of weeks. Amidst a struggling site, this 834 problem is compounding problems for everyone, including the health plans. The 834 transaction error involves the backend enrollment happening between the government and insurance carrier systems. The data being transmitted is inaccurate, and the health plans are not able to process enrollments correctly, leading to incorrect enrollments, even for those who have finally managed to go through the backbreaking process.
With all this and a lot more going on, the administration has listed some important action items that they are seeking to resolve:
• Fixing the 834 error – The first action point is to find resolution for the back end 834 transaction error. Through this, they will at least be able to remove spurious data moving in the system that is making matters worse for everybody.
• Revamping healthcare.gov – The administration has finally been able to issue substantial improvements for the official federal marketplace website. Although the progress is incremental now, the magnitude of improvements and bug fixes continuing to coming in is huge and the government expects to get the site in a fully functional, error free state by end of November.
• Prepare the site for bulk enrollments – Once the 834 error is out of the mix, officials plan to make the site robust enough to handle bulk enrollments before it gets completely fixed. While this would not mean a completely error free experience, at least not till all the errors are sorted out, it will help citizens and navigators maneuver the path to enrollments through a buggy site.
Although the challenges are many and we are already in the fifth week of rollout, the improvements are heartening. The Obama administration is getting a handle on things and is steering the project in the right direction – towars complete implementation of health reform. As the next couple of weeks go by, we should see a substantial overhaul of the federal health insurance marketplace.