CMS Admits People Enrolled In Obamacare May Not Actually Be Covered

The Obama administration finally had to admit that many Americans who think they now have health insurance coverage after signing up through the Obamacare exchanges may not be covered after all. Every one who has signed up better double check before the first of the year, or they could be in for a rude awakening when they visit the doctor.

Healthcare.gov may be working better and somewhat faster for consumers attempting to enroll in plans, but a new wrinkle has emerged: there is no payment mechanism for insurers to get cash from the federal government subsidies.

The Centers for Medicare and Medicaid Services (CMS) confirmed the problem Tuesday night. The mechanism would enable the government to pay billions of dollars to insurance companies for subsidized and cost-shared plans has yet to be built—and experts say consumers may get squeezed in the meantime.

Healthcare.gov has been plagued with error messages and glitches since its Oct. 1 debut that have prevented consumers from signing up for insurance. The White House set a November 30 deadline to fix the problems. Now, CMS claims the site can now handle 50,000 visitors at a time, and up to 800,000 consumers a day.

There have also been issues with insurance companies receiving 834 forms, which detail a customer’s eligibility for a subsidy. (Read More)

That’s not the only problem with the insurance companies. The government still hasn’t figured out yet how it’s going to pay them for the parts of plans that are subsidized. According to Fox Business, this could put some small insurers out of business.

For subsidized plans to go into effect under ObamaCare, the government needs to hold up its end of the bargain – by paying its portion of premiums and cost-sharing payments.

But some experts say a last-minute fix that would enable insurance companies to seek payment from the government for these costs may not be the Hail Mary intended by the Obama administration.

The Centers for Medicare and Medicaid Services (CMS) has not yet completed the back-end technology necessary to automatically transfer payment from the government to insurance providers for subsidized plans. Until this aspect of the website is fixed, the administration has proposed a temporary workaround that will allow insurers to estimate the bill owed by the government, submit that bill and then receive payment from the government.

These new steps, however, place an additional burden on insurance companies – and could actually cause some insurance companies to close up shop. (Read More)