U.S. says HealthCare.gov enrollment appeal hearings to begin soon
Mon, Feb 3 2014
WASHINGTON (Reuters) - The Obama administration on Monday said it will soon
begin hearings to resolve problems for people who enrolled in health insurance
through the Obamacare website HealthCare.gov, only to encounter errors including
unnecessarily high costs.
The U.S. Centers for Medicare and Medicaid Services (CMS), the lead agency
responsible for implementing the healthcare reform law, issued a statement
saying it was reaching out to consumers with error-ridden enrollments to help
them complete applications for coverage without a formal appeal.
The statement came in response to a Washington Post report that said about
22,000 Americans have appealed to CMS for help fixing enrollment mistakes that
have led to excessive charges, enrolled them in the wrong health plan, or denied
them coverage altogether.
The appeals have hit a technological dead end, the newspaper reported,
because the administration has yet to complete the technology infrastructure
necessary to manage the appeals process.
Obamacare's rocky implementation has already weathered paralyzing glitches
and a public outcry over insurance policy cancellations for millions of people
in the health plan market for individuals.
"CMS is working to fully implement an automated appeals system. Until we have
that functionality, we are putting in place a manual review process wherever
possible and expect hearings to begin soon," said the agency.
"In the meantime, CMS is reaching out to these consumers to provide
assistance so they can successfully complete their application without the need
to complete the appeals process."
CMS did not confirm the number of appeals reported by the Post but said those
filed are "largely related to earlier technology problems that have since been
fixed."
A CMS spokesman declined to say how soon hearings might start. But analysts
said a system would have to be in place before March 31, the end of the
Obamacare open enrollment period for obtaining health coverage this year.
The Patient Protection and Affordable Care Act, President Barack Obama's
signature domestic policy achievement, is intended to extend private health
coverage to the uninsured by selling private plans at subsidized rates through
new marketplaces. The law also calls on states to expand Medicaid coverage for
the poor.
HealthCare.gov, the Web portal for a federal marketplace that spans 36
states, crashed soon after its October launch, blocking access to some while
saddling others with inaccurate enrollment files. Four months later, CMS is
still scrambling to complete back-end systems that would allow the federal
marketplace to pay government subsidies to insurers on behalf of low-income
beneficiaries.
Republicans in Congress pounced on news of the appeals problem as fresh
evidence that the healthcare law's individual mandate should be delayed. The
mandate requires most Americans to be enrolled in health coverage by March 31 or
pay a penalty.
"Over four months after launch, the administration still does not have its
act together. They appear to be incapable of addressing Obamacare's failures,
unfairly leaving Americans on the hook," said Joe Pitts, chairman of the House
Energy and Commerce health subcommittee.
(Reporting by David
Morgan and Susan
Cornwell; Editing by Karey Van Hall and David
Gregorio)