HealthCare.gov Headaches Persist As Website Still Not Fully Constructed

July 25, 2014

The botched rollout of HealthCare.gov led to frustration and confusion in the fall of 2013 as Americans attempted to navigate the failed website. The Energy and Commerce Committee learned last November that even as some elements of the website were slowly brought into function, the backed of the exchanges had still yet to be built. The committee recently confirmed that the backend is still incomplete, now just months away from the second open enrollment period (delayed by the administration from October 1 to November 15). The AP reports that these failures have left millions of Americans with conflicting estimates for their subsidies, and leaving some without insurance altogether. The Energy and Commerce Subcommittee on Oversight and Investigations will hear from the Government Accountability Office and the Centers for Medicare and Medicaid Services next Thursday about the failures that plagued last fall and the status of implementation today.  

July 24, 2014

Varying Health Premium Subsidies Worry Consumers

Linda Close was grateful to learn she qualified for a sizable subsidy to help pay for her health insurance under the new federal law. But in the process of signing up for a plan, Close said her HealthCare.gov account showed several different subsidy amounts, varying as much as $180 per month.

Close, a South Florida retail worker in her 60's, said she got different amounts even though the personal information she entered remained the same. The Associated Press has reviewed Close's various subsidy amounts and dates to verify the information, but she asked that her financial information and medical history not be published for privacy reasons.

"I am the kind of person the Affordable Care Act was written for: older, with a pre-existing (condition) and my previous plan was being cancelled. I need it and I'm low income," said Close, who has spent more than six months appealing her case. "The government pledged to me that original tax credit amount. It's crazy." …

The differing subsidy calculations are part of a mountain of data conflicts affecting at least 2 million people who signed up for coverage in the new health insurance exchanges. Most of the discrepancies involve important details about income, citizenship and immigration status - which affect eligibility and subsidies.

Some supporters of the law fear low-income consumers will owe the government money because their subsidy was incorrect. Federal health officials have repeatedly stated that the IRS will have the final say, regardless of what figures were generated on healthcare.gov. The IRS can deduct the amount from consumers' tax refund or tell consumers they owe the government money. Or, conversely, consumers could receive money back if they took too low of a subsidy. …

Many consumers were required to submit additional paperwork to complete their applications, including citizenship or tax information, and that additional information also could have generated a different subsidy amount.

In Roanoke, Virginia, insurance agent Carol Taylor had seven clients who remain uninsured because of unresolved subsidy questions after federal officials asked them to submit additional documents to verify their income.

"They are just sitting there. They haven't picked (a plan) because they can't get a correct answer, and they'd rather wait until they get through the verification process to make sure they get the right amount," Taylor said.

Although the enrollment deadline has passed, federal officials can grant consumers special status that would allow them to pick a plan now.

About half of the two dozen consumers Taylor helped enroll in the marketplace had problems with eligibility results. She spent hours on hold with the federal government trying to resolve the issue for five clients and was told consumers should go with the lower subsidy amount to avoid having to repay any money later in case of an error.

Delaware insurance agent Nick Moriello's client was quoted an $87 subsidy from healthcare.gov and a roughly $30 subsidy from the federal government's hotline. In the meantime, his client isn't buying a plan.

"She said if I'm only going to be eligible for the $30 credit, it's not going to be affordable for me so I'll wait," he said.

Read the article online HERE.

 

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