A little over a week ago, reports surfaced revealing that the so-called “back end” of the Healthcare.gov website remained months away from being completed. On Tuesday, the consequences of that ongoing fiasco were revealed. A pair of reports released by the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) reveal “internal” controls for evaluating healthcare applications are ineffective, and 85 percent of 2.9 million data “inconsistencies” on ObamaCare applications cannot be resolved, even after nine months of attempting to do so.
“The federal marketplace was generally incapable of resolving most inconsistencies,” one OIG report said. “Without the ability to resolve inconsistencies in an applicant’s eligibility data, the marketplace cannot ensure that an applicant meets each of the eligibility requirements for enrollment in a QHP [qualified health plan] and when applicable, eligibility for insurance affordability programs.”
For clarity sake it should be noted that 2.9 million inconsistencies does not mean there are 2.9 million applications in error. Due to the series of questions applicants are asked about their citizenship, Social Security number, income or incarceration status, it is possible that some applications may have multiple inconsistencies. Furthermore, those inconsistencies may not be inaccurate information, but rather data that cannot be matched with government sources from numerous agencies. “In some circumstances, the marketplace cannot verify an applicant’s information through available data sources,” the other report explained. “When this happens, it is referred to as an inconsistency. This may arise when Federal data available through the Data Hub or data from other sources are unavailable or do not exist, or because the information on the application does not match the data received through the Data Hub or from other data sources.”
The two most prominent unresolved inconsistencies were “citizenship and income.”
Only citizens and those with legal residence in the United States are eligible for ObamaCare. Yet in keeping with his determination to send America’s illegal alien population mixed messages, President Obama promised during a March interview with Telemundo that “none of the information that is provided in order for you to obtain health insurance is in any way transferred to immigration services,” he explained. “So that’s something we’ve been very clear about. If you live in a mixed status family, then the son who could potentially be eligible for the children’s health insurance program or some other mechanism to get health insurance, he needs to be signed up. And the mother should not be fearful that in any way that’s going to affect—of course I understand the fear.”
That fear didn’t prevent 4000 illegals in Oregon from being signed up when state officials “accidentally” steered them from Medicaid to ObamaCare, despite the reality that the applications were hand-processed—because the state’s computers were offline and its software architects under investigation for possible fraud. And DHS Secretary Jeh Johnson doubled-down on Obama’s message in an open letter to the same “mixed status families,” before taking it one step further. “Enrolling in health coverage . . . will not prevent your loved ones who are undocumented from getting a green card in the future or who do not yet have a green card at risk,” he promised.
As for income, proper information is necessary in order to determine one’s eligibility for taxpayer-subsidized health insurance, as well as ongoing subsidies of one’s monthly premiums. As recently as last month the Washington Post reported that more than one million Americans may be getting incorrect subsidies because the incomes they reported “differ significantly” from those on file with the IRS. And while the government requires enrollees with discrepancies to verify their information within a 90-day window, only a fraction have done so. Yet the Post reveals that even those who have complied remain in limbo, because “important aspects of the website remain defective — or simply unfinished.”
The report seemingly updates that assessment, noting that the “number of applicants who may have exceeded the 90-day inconsistency period or for whom the inconsistency period was extended by the federal marketplace because the applicant demonstrated a good-faith effort in obtaining satisfactory documentation” remains undetermined.
The spectacular failure of the website’s front end last October necessitated the diversion of all resources to fix it, delaying the completion of the back end. A January deadline for addressing the problem soon became mid-March. But by mid-April, when Politico’s Kyle Cheney asked officials at the Centers for Medicare & Medicaid Services (CMS) when they expected the back end to be ready, they refused to give him an answer. As a result the government will use an “interim” accounting process that amounts to a combination of working by hand, and using informed guesses to resolve the inconsistencies.
Insurance industry consultant Robert Laszewski illuminates what will likely happen when the permanent system is finally engaged. “We have the mother of all reconciliations coming,” he predicted. “It may be that the administration will not be able to give us a credible enrollment number until then because we really need a reconciliation to accomplish that.”
In other words, the 8 million signups touted by President Obama and his media sycophants remains little more than unproven hype. Moreover, it remains to be seen what sort of reconciliation will be made in a number of different areas. For example, enrollees with improper income information may have their premiums adjusted up or down, receive cash refunds or be forced to make additional payments. Insurance companies’ finances could also be affected, precipitating premium spikes or withdrawal from the marketplace by companies that feel shortchanged. Even the estimates of ObamaCare’s overall costs may be subjected to radical readjustments. In short, until the back end of the system is completed, the true effects of ObamaCare cannot be fully ascertained.
Furthermore, the Healthcare.gov website was hardly an anomaly. Eleven of the 15 states (including Washington, D.C.) running their own exchanges submitted reports to the HHS inspector general. They detailed 1.2 million inconsistencies, but it remains unclear how they are counting them, so the data cannot be combined with federal totals. Seven states said they cleared up inconsistencies without delay. However the latter report illuminates that technological failure was not confined to the federal website. ”During our review, 4 of the 15 State marketplaces reported that they were unable to resolve inconsistencies (Massachusetts, Nevada, Oregon, and Vermont),” it stated. “They attributed this inability to failures in their information technology systems.”
Both reports chronicled the time period only from October through December of 2013. The more extensive of the two reports was required by House Republicans as part of last year’s deal ending the partial government shutdown. It was based on their now-validated assertion that ObamaCare was not set up to properly verify the various eligibility requirements contained in the law.
Senate Republican Leader Mitch McConnell (R-KY) took the administration to task in that regard. “From today’s reports, it appears that then-HHS Secretary Kathleen Sebelius provided a misleading certification to Congress earlier this year that the Obamacare exchanges could and would verify that individuals receiving tax credits and cost-sharing assistance are actually eligible to receive these taxpayer-provided subsidies,” he said in a statement. “This report is one more example of just how flawed the president’s health care law is.”
Not just flawed. Fatal. Linda Rolain was one of 150 Nevadans suing Nevada Health Link contractor Xerox for enrollment errors that left them without insurance they had paid for. That lack of coverage cost Rolain her life, when she was unable to receive treatment in January for an aggressive brain tumor. “Ms. Rolain should have had coverage in January,” said local insurance broker Pat Casale. “(She and her husband) did everything they could to facilitate the acquisition of a health plan. She suffered and she died all because of the negligence of a vendor who should not even be in the industry.”
According to Rolain’s husband Robert, the problems they encountered were depressingly familiar. They tried to sign up for a policy in November well before the original Dec. 15 deadline for January coverage. They were unable to do so and settled for a policy that took effect in March. But Xerox staffers miscommunicated the policy’s effective date, leaving them hanging until May. In June, Rolain entered hospice. “She had no chance because of the delay,” Casale explained.
When Tuesday’s reports came out, Democrats and CMS pushed back on the criticism. “It is no surprise to anyone that the first few months of the marketplace rollout were rocky,” said Sen. Tom Harkin (D-IA), chairman of the Senate Health, Education, Labor and Pensions Committee. “Since then, we have signed up eight million Americans.” CMS spokesman Aaron Albright was equally effusive. “CMS is working expeditiously to resolve inconsistencies to make sure individuals and families get the tax credits and coverage they deserve and that no one receives a benefit they shouldn’t. We are actively reaching out to consumers to provide additional information that supports their application for coverage and verifying their information every day.”
It’s no surprise now that the rollout was rocky, Senator, but an Obama administration fully aware of it before the initial launch last October refused to level with the public when it mattered most. And the so-called 8 million signups is a transparent effort to keep a false narrative intact, even as the reports completely debunk it. As for the notion that CMS is “working expeditiously,” such happy talk can’t obscure the reality that they have no idea when the back end of the system will be up and running.
The watchdog office issuing the reports has called on the Obama administration to publicly explain how and when—specifically–the data problems in the 36 states where the federal government is operating marketplaces will be resolved. One is left to wonder how many more people will share Linda Rolain’s fate in the interim, even as the massive bureaucratic failures that have come to represent the real “signature achievement” of ObamaCare play themselves out.
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