Don’t Expect ‘Perfection’ on Health Care Site

The federal health insurance website is trying to resolve glitches and security questions raised by the Government Accountability Office, so people can safely and successfully sign up for insurance at open enrollment Nov. 15.

Much of the Obama administration’s success in enrolling 8.1 million people in health insurance over the past year was overshadowed by the momentous problems with and several state exchanges. As administration officials prepare to test the site with insurers Oct. 7, they’re trying to manage expectations while portraying some confidence.

Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner told a House panel Thursday that there will be “visible improvement, but not perfection” on

Companies and state officials, who will process millions of applications for insurance and Medicaid, hope the files that reach them are far more complete and accurate than they were during the last enrollment period. Missouri found it couldn’t enroll up to 90% of about 80,000 Medicaid applications it received because of problems, says Matt Salo, executive director of the National Association of Medicaid Directors.

“The challenges we saw were legion and well-documented,” Salo says. “It’s not going to be that bad, (but) neither is it going to be smooth and seamless.”

Administration officials hope testing of will help.

“They are trying to move away from a big bang approach and moving towards an incremental rollout approach,” says Sanjay Singh, CEO of hCentive, which took over the Massachusetts site this year and is developing the federal small business SHOP exchange.

Consumers will be able to browse plans at a still unknown time before Nov. 15. They will not have to set up an account — a process that stalled many during enrollment malfunctions.

Insurance customers should test the site to see how well it works for them, because their insurance rates may have changed. Some may find better deals on premiums, while other customers have had changes in their income this year that will affect their subsidies.

Those who do nothing and are automatically re-enrolled will get their 2014 subsidy. If their income went up, that subsidy would be too high, which means it would have to be repaid at tax time. If their income went down, consumers could miss out on a higher subsidy.

Adding to the pressure on, Oregon and Nevada residents will buy their insurance through the federal site this fall. Both states had troubled rollouts similar to the federal launch. The glitch-plagued Maryland site decided to stay on its own and will gradually open its site to consumers, insurance agents and social service groups over the course of a week starting Nov. 15 to help the state identify and fix problems more quickly. Massachusetts is making a third attempt to launch a site consumers can actually enroll on.

“Health plans are still worried about the back end of the website working properly and smoothly,” says Ceci Connolly, managing director of consulting firm PwC’s Health Research Institute.

Security returned as a concern this month when CMS announced a data breach at Thursday, the GAO released a report charging security for the site fell short in more than 20 areas, including password strength. Tavenner told the House Government Oversight Committee that nearly all the problems have been resolved:

CMS spokesman Aaron Albright said the site’s security meets industry best practices and meets or exceeds federal standards. The department is working closely with GAO on the site’s security, he said.

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