The Obama administration says it's making progress on back-end issues with HealthCare.gov, but it has only recently gotten a handle on how bad those issues are.
The Centers for Medicare and Medicaid Services has clearly made a lot of progress tackling the most visible, and thus the most embarrassing, problems with the enrollment website. But CMS has been slower about fixing the back end — errors in the information the site sends to insurance companies.
In October and November, up to 25 percent of enrollments had some sort of error, CMS Communications Director Julie Bataille said Friday. She said CMS believes the error rate is now down to about 10 percent, but she stressed that the estimate is preliminary, because the agency has had a hard time even knowing whether it's catching all the errors that are happening.
Insurers have complained since the site's Oct. 1 launch that they couldn't process a lot of the information they were getting from HealthCare.gov. They weren't sure who had actually enrolled, or they got inaccurate or incomplete information about those people. These errors could have major real-world implications if, for example, people think they're covered but their enrollment didn't actually go through to an insurance company.
Bataille said there have been three main types of errors with the "834" transmissions to insurers: 834 forms that were not submitted at all; duplicates; and transmissions that were submitted but contained errors.
Getting a handle on the error rate has been difficult because it's hard to know how many 834s are simply missing, and not all errors are apparent as errors.
Although the Obama administration got the site's user experience fixed before its back-end problems, Bataille said CMS and its lead contractor for HealthCare.gov repairs, QSSI, now have a dedicated team in place for these issues.
"We are doing this work intensely now," she said.
Insurers were able to sort through 834 issues by hand in October and November, when only a trickle of people could actually make it through the site to enroll. They feared during that time that the White House would fix the site's politically embarrassing front end first, flooding them with more bad information than they could handle.
Insurers say the process is getting better, but that they're still seeing errors.
This article is from the archive of our partner National Journal.