It’s not old, its retro

There have been a couple of operational glitches during the first week of the Exchange policies going live.  Betty catches the problem that is having problems dealing with changes in family situations, most notably adding a baby to a family’s policy.

The bigger issue is a Medicaid enrollment file problem as the Washington Post reported earlier this week:

More than 100,000 Americans who applied for insurance through and were told they are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) remain unenrolled because of lingering software defects in the federal online marketplace, according to federal and state health officials.

This problem is mainly concentrated in Ohio and Pennsylvania.

Both of these problems are the equivalent of stubbing one’s toe.  They are not fatal problems.  Both problems will probably have the same work-around for the next couple of months.  Enrollments and policies will be back dated, and claims will be retroactively paid.

This is not a big deal.

Retroactive enrollment has happened all the time in the pre-Obamacare insurance industry.  Yesterday a co-worker retro-added a group to a 2nd quarter 2013 start date.  15% of my time last year was spent on a project which retroactively changed tens of thousands of claims.

Babies are even easier to deal with.  Under previous law, babies were always retro-added to their day of birth as long as the insurance company was told within 30 days of birth.  Some states required all babies to be covered by their mother’s policy for the first thirty days of their life.  Going forward, parents should do the same thing with their Exchange insurance as parents have done with private insurance when they have a newborn; call their private insurer and fill out a form to get the kid covered.

Systemically, insurance companies would prefer not to retro anything as any process that is touched by human hands is more expensive than allowing automated processes to deal with standard operating procedures.  Short term retro-modifications as transitions from an enrollment and payment system to a comprehensive member management system will work.

20 replies
  1. 1
    Ghayduke (formerly Lojasmo) says:

    That’s good news. Thanks again, Richard, for your very informative posts on this subject.

  2. 2
    Ghayduke (formerly Lojasmo) says:

    Since I’m in moderation hell for missing my last parenthesis.

    A nurse colleague of mine was recently relaying a story about a laboror who was lamenting a $10K deductible on a minnesota exchange plan, and how he was just going to pay the fine.

    Took me literally five minutes on MNSure to figure out that the VERY highest deductible was $6500, and that a 45 year old nonsmoker can get an UNSUBSIDIZED plan with a $100 deductible for $450/month.

    I left a snarky not from the “fact fairy” on my colleague’s desk.

  3. 3
    Betty Cracker says:

    Yep — any parent who has had to add a newborn to a policy should recognize that this isn’t a huge deal or anything new and unique to Obamacare. That won’t stop the screechers from trying to make hay of it. But I doubt it’ll resonate much beyond the wingnut echo-chamber.

  4. 4
    aimai says:

    Having had two children I can attest that there is always some paperwork. Its nothing to freak out about. Even less so now that one feels that there are all kinds of government agencies looking over the insurance companies shoulders.

  5. 5
    Derelict says:

    I’m in the supposed ObamaCare paradise of Vermont, where our Website has been balky at best, non-functional most of the time. I applied last month, and went through the process that ended with me receiving an email telling me to check my message for my premium notice. During the ensuing two weeks it took to finally get back to my messages page, my previous coverage had already lapsed (why pay two premiums?).

    So, now I may or may not have any health insurance. Or maybe I have two policies.

    Oh, and BTW, my new policy (if I get it) saves me $5 in monthly premiums while tripling my deductible and quadrupling my out-of-pocket.

  6. 6
    muricafukyea says:

    Ah yes, time for another negative piece from the accidental Ball Juice Obamacare troll. It’s not even a odd day this time. Maybe he’s switching it up for the new year.

  7. 7
    Ghayduke (formerly Lojasmo) says:


    “Oh, and BTW, my new policy (if I get it) saves me $5 in monthly premiums while tripling my deductible and quadrupling my out-of-pocket.”

    Why the fuck did you do that?

  8. 8
    Ghayduke (formerly Lojasmo) says:



  9. 9
    🎉 Martin says:

    Timely piece worth a read.

    But a lack of fact checkers does not explain why the newspaper ignored the news that one of its “victims” had found good coverage. No editor’s note. No comment. No clarification.

    Why is this important? This major daily’s nearly 200,000 daily readers saw the story that would lead them to believe that Americans who received cancellation notices were “left in limbo.” Most, it concluded, would wind up uninsured – or paying more than they could afford. As I’ve pointed out many times – and as more and more coverage is revealing – the opposite is true.

  10. 10
    Joel says:

    @Derelict: where in VT do you live?

  11. 11
    raven says:

    @muricafukyea: Hey go fuck yourself punk.

  12. 12

    Having just lost my health insurance due to my asshole boss cutting my hours from 40 to 20 a week, I guess I am now going to have to look into the new exchanges or pay the fine. Thanks to my asshole GOP governor (McCrory) we don’t have the Medicaid expansion so I am screwed.

  13. 13
    JoyfulA says:

    Pennsylvania doesn’t have Medicaid extension so maybe it isn’t “lingering software defects.”

  14. 14
    Steeplejack says:


    Okay, you scored a lucky hit on DougJ downstairs, but this is back to your usual bullshit. I shall bid you good day, sir. I said good day!

  15. 15


    I know several of us already said this to you, but you should use those 20 extra hours of free time to find a new FT job so you can tell that guy to kiss your arse.

  16. 16
    Scamp Dog says:

    I wasn’t able to sign up for a plan in time to get insurance starting January 1st, because I had to be denied Medicare coverage before I could get the Obamacare subsidy. That happened sometime during the holiday, so this morning I got a call from Connect for Health Colorado, and made arrangements to have them call me back when I could get on line (necessary part of the process).

    I got the call-back an hour later than scheduled, but after 49 minutes on the phone, I was signed up for health and dental insurance, for the first time in 9 years. So a big thank you to Shannon and the other good folks at Connect for Health Colorado! Now I just have to avoid drastic disease or injury for the next 28 days. Oh, and stump up the cash for the monthly payments. Still, it’s a good thing and I’ll figure out some way to make it work.

  17. 17
    IowaOldLady says:

    I heard an ACA story from our host on New Year’s Eve. His daughter is an actress in her late twenties and had a crap insurance policy for about $100/month. She tried to sign up on the exchange and every step of the way, she was basically acting out the national news for them. First she couldn’t get on. Then she got glitched out. And so on.

    Anyway, long story short, she wound up with a much better plan for less money.

  18. 18
    superfly says:

    I have a question, Richard.

    Is there a reason an insurance company (Assurant Health) would sell ACA compliant policies (so they say), but not sell them via the CoveredCA website, selling them directly only?

    Does doing so free the company from certain rules, regulations, etc.? something else?


  19. 19
    ted says:

    My current problem is that I’m enrolled and need to pay my first bill. But the bill hasn’t arrived and I have been advised to call Anthem Blue Cross (this is in California) to get my customer number…but the last time I tried to do that I was on hold for three hours (!!!!) and then they just hung up. Aaaaaarggggghh. Will try again Monday.

  20. 20
    qtip says:

    All these ‘glitches’ may ‘work themselves out’ but they sure are annoying to those of us experiencing them. I spent many hours trying to enroll on the DC exchange throughout November and December. The website says I completed my application successfully but then the applications just disappear…the DC people can’t find them in my account and Blue Cross never gets them. I have no idea if I have insurance or not. The DC exchange helpers say I should just wait for a call from Blue Cross. Blue Cross won’t let me pay my premium until they get paperwork from DC. I’m not sure how long I should wait since the payment deadline is coming up soon. If I do succeed, my premiums will be about $100/month higher than my previous plan that is no longer being offered.

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