There have been a couple of operational glitches during the first week of the Exchange policies going live. Betty catches the problem that healthcare.gov 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 HealthCare.gov 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 healthcare.gov transitions from an enrollment and payment system to a comprehensive member management system will work.