By Sharon Begley
NEW YORK (Reuters) – The District of Columbia’s online health insurance exchange – one of 51 set up under President Barack Obama’s healthcare reform law – will be unable to perform two key functions when it opens on October 1, exchange officials announced on Wednesday.
The District joins Colorado and Oregon on the list of “Obamacare” exchanges hobbled by problems with information technology (IT), contributing to expectations that Obama’s signature domestic achievement will get off to a slow start when the exchanges go live next Tuesday.
The “DC Health Link” web-based marketplace, where residents of the nation’s capital who do not have other coverage will be able to purchase policies, will lack the ability to calculate whether someone is eligible for Medicaid. It will also be unable to calculate the size of federal subsidies, if any, that a customer qualifies for.
Although numerous online tools created by nonprofit and other groups have offered subsidy calculators for months, “calculating subsidies for real is admittedly more complicated,” said one expert. “For example, you have to make sure the family isn’t eligible for Medicaid, and you have to collect more detail about their income. That said, I am frankly a little mystified why they couldn’t get this right in time.”
Under the law, someone whose income is less than four times the federal poverty level, or $45,960 for an individual and $110,280 for a family of five, can receive federal subsidies in the form of tax credits to defray the cost of monthly insurance premiums.
Subsidies are key to making the policies fit the budgets of many uninsured Americans, a primary goal of the 2010 Affordable Care Act. Without subsidies, sticker prices for an individual average $328 but can reach hundreds of dollars higher. But with them, according to the Department of Health and Human Services, an estimated 6.4 million people will be able to purchase policies for less than $100 per month.
Not being able to learn how much of a subsidy one qualifies for could therefore be a significant deterrent to applying for coverage.
“DC Health Link is not currently deploying the function that makes new Medicaid eligibility determinations and calculates tax credits,” Mila Kofman, executive director of the DC Health Benefit Exchange Authority, said in a statement. The reason, she said, is “a high error rate discovered through extensive systems testing.
People who might qualify for Medicaid coverage or tax credits will be able to submit an online application for coverage if they are willing to do so without knowing what they’ll be paying. Experts will determine their eligibility off-line and applicants will be notified in early November, Kofman said.
Her statement emphasized that DC Health Link “will open for business October 1″ and said, “We are excited to announce that … almost all functionality is operational for individual consumers.” Only two sentences buried in the nearly 800-word statement mentioned the glitches.
D.C.’s setback is even more severe than other states’.
On Monday, employees running Connect for Health Colorado told board members that the exchange would not be able to calculate federal subsidies either, at least for the first few weeks.
Instead, Coloradoans who wish to buy a policy and learn their eligibility for subsidies will be directed to call customer service representatives, who will do the calculations manually.
Connect for Health Colorado was not “completely satisfied” with the accuracy of the tax credit calculations, said Ben Davis, an outside spokesman for the exchange. “There are 100,000 scenarios they want to test for” – combinations of income, family situation and other factors – “and it takes X amount of time. We just did not have enough time to test.”
Colorado will therefore spend two more weeks testing the system “to make sure every possible scenario has been accounted for and providing an accurate response,” Davis said.
Connect for Health Colorado will have 187 customer service representatives at its call centers throughout the enrollment period, which ends on March 31.
In another potential glitch, Oregon’s exchange reported on Wednesday that its IT problems were causing information about policies that insurers plan to sell on Cover Oregon to appear incorrectly on a test site. As a result, crucial details such as deductibles are incorrect.
“We are in a validation process with our carriers,” executive director Rocky King said.
State-based exchanges being run by the federal government reported similar display problems last month.
HHS spokeswoman Joanne Peters played down the IT snafus, saying in a statement that “there will be a marketplace open in every state and D.C. on October 1, where families can comparison shop for quality, affordable health coverage.”
HOUSE REPUBLICANS DEMAND OBAMACARE DELAY
WASHINGTON (Reuters) – House of Representatives Republicans on Thursday refused to give in to President Barack Obama’s demands for straightforward bills keeping the government running beyond September 30 and increasing borrowing authority to avoid an historic default.
They said they will seek a one-year delay in the full implementation of the new national healthcare law known as “Obamacare” in return for raising U.S. borrowing authority by enough to let Treasury borrow through the end of 2014.
Even as some senior Republicans predicted there would be no government shutdown on October 1 or credit default next month, House Speaker John Boehner warned that his chamber is unlikely to sign off on a government spending bill the Senate is expected to pass in coming days that simply extends current funding.
“I do not see that happening,” Boehner told reporters at a news conference after a closed meeting with his rank and file.
House Republicans passed an emergency spending bill last week to defund Obamacare. But with Democrats standing firm against that tactic, they have begun looking at other pet projects to attach to the spending bill.
The Democratic-led Senate in coming days intends to pass a “clean” bill to keep the government running from October 1 to November 15 and send it to the Republican-controlled House as the clock ticks down to the expiration of government funding at the end of the current fiscal year at midnight Monday.
Republican Representative Tom Cole said there are discussions in the House about attaching a measure, which he did not specify, to the funding bill that has bipartisan support in the Senate.
One such measure could be the proposed repeal of a medical device tax that would collect $30 billion over 10 years and help pay for some of the costs of Obamacare.
Senate Democratic aides have insisted, however, that a measure like that, even though it has broad bipartisan support, should not be attached to this emergency spending bill, and some senior Republican and Democratic senators have already rejected the idea.
House Republicans are also challenging Obama on the debt limit increase that the Treasury Department says is urgently needed by October 17.
House Republican leaders said that in addition to seeking to delay Obamacare, they will also attach some spending cuts and other initiatives to a debt limit bill, something that Obama has said he would not tolerate.
Obama wants a debt limit increase with no strings attached.