Better Tell Patients to Wait Until Dec. 1 to Use Healthcare.gov

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The national website for health insurance, Healthcare.gov, will be in “good working order” by the end of the November, according to the government official in charge.

Marilyn Tavenner, administrator for the Centers for Medicare and Medicaid Services, came before the House Ways and Means Committee on Tuesday, and opened with an apology to the American people for the website’s problems, which her agency orchestrated. Her boss, Health and Human Secretary Kathleen Sebelius, made the same apology when she appeared before the House Committee on Commerce and Energy this morning.

Director Tavenner’s statement can be downloaded here (PDF, registration required):  (You must be logged in to download this file. Don't have an account? Register for free and you'll be returned to this page.)

Sec. Sebelius’s statement can be downloaded here:  (You must be logged in to download this file. Don't have an account? Register for free and you'll be returned to this page.)

While the website’s problems have political ramifications, the bigger challenge will be to healthcare providers who will bear the burden of helping their patients get coverage.

The good news appears to be that the rollout of the state-run websites have encountered minor problems, nothing compared to the issues with the federal site, which actually went down during Sec. Sebelius’s testimony. For those providers in states covered by the national healthcare insurance marketplace, there are looming “gotchas” as a result of the website snafus.

Insured individuals. Insurers across the country have cancelled individual insurance policies for hundred of thousands of patients. There are no official figures as to whether this is a higher churn than normal, but many of the insurers have announced they are dropping the policy holders because of regulations that resulted from the Patient Protection and Affordable Care Act. For providers, the long-term results should be a positive, because the insurance options available through the exchanges will be superior to individual plans, at least to those patients posing a higher risk of failing to live up to the financial responsibility. In the short term, however healthcare providers will have to devote resources to help patients losing insurance to migrate to new policies on the exchanges.

Young Americans. Young adults, among the most tech-savvy, also have the highest expectations with regard to website performance and functionality. In answer to Rep. Jerry McNerney (D-Calif.), Sec. Sebelius testified that special efforts would be made to reach out to this population, but only after Healthcare.gov is fixed.

Healthy Americans. The “secret sauce” of healthcare reform is to have healthy Americans join the larger insurance pool to help subsidize the medical costs of those in poorer health. In the end, despite the website problems, the law requires that all Americans who are able must be covered by insurance. The stick to the Affordable Care Act, according to Sebelius in her testimony, is the individual mandate within the ACA. For 2014, the penalty for failing to comply is $95, less than one month’s insurance payment for most Americans. However that penalty grows to $695 per person by 2016.

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Posted in Denials Management, Medical Receivables, Patient Access, Patient Experience, Patient Financial Services .

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