« How we pay for those subsidized Affordable Care Act health plans | Main | Start-up Obamacare website gets media high-fives »

In Washington, 8,000 early Obamacare enrollees given wrong subsidy info


The state-run Washington Health Benefit Exchange was a shining star in rocky rollout of the Affordable Care Act's online marketplaces. But a simple income reporting snafu means that about 8,000 Washington residents will soon receive letters informing them that the price they are expecting to pay for health insurance purchased on the new online exchange marketplace is incorrect, Kaiser Health News reports. 

In late October, the exchange caught a major error that came about in calculating the tax credits that the early enrollees qualified for to help pay their insurance premiums. It has since then been correcting the premium subsidies that the enrollees are qualified to receive.  

Those affected are early birds who enrolled  in health plans during the first few weeks after the Oct. 1 launch of the state's online healthcare marketplace. During that time, the state's website was reporting monthly incomes to the federal data hub, which uses annual incomes to compute the tax subsidies applications are eligible for, KHN says.

It's fixed now, but the error took down the state's reputation a notch as one of the country's most successful online insurance markteplaces.  




But the federal hub was expecting annual income, not monthly, which resulted in the miscalculation.


Approximately 8,000 Washington residents were affected, which meant they were told they qualified for a higher tax credit amount than they actually qualified for based on their income and household size.


How could such an error occur? “We’ve asked ourselves that many times,” Onizuka said. “We are still trying to figure out how this happened.”


So far, Washington is the only state-run exchange that has reported making this type of error to the Centers for Medicare and Medicaid Services (CMS), which oversees the online insurance marketplaces and the federal hub.


The letters being sent to enrollees will be the first direct communication from the exchange informing them that the amount of their premium subsidy is less than they thought.


The mistake could mean a lot of work for people who already went through the process of choosing a health plan, as well as for brokers and in-person assisters who helped them.


Deja Vu?


Some people will probably have to go through the selection process all over, said Chris Free, an insurance broker at Rapport Benefits Group in Tacoma, who has been advising clients on enrolling in the health plans available through the exchange.


“People may have selected plans that are no longer in their budget” once their tax credit is recalculated, Free said. For those clients, “we’ll need to sit down and help them re-evaluate their decision,” he said.


Another problem for the exchange has been the capacity of the customer-service center to handle calls seeking information and assistance with their applications.


The exchange had expected about 2,000 calls a day. But the actual number is currently about 3,000 to 4,000 a day, Onizuka said.


In response, the exchange announced two weeks ago that it plans to add 145 new customer-service representatives through mid-December, which will double the call-center staff.


The first 20 of the new hires are going through training and are expected to start working the phones next week, Onizuka said.


A key goal is to significantly reduce the average wait time for callers, which is still about 20 minutes, Onizuka said.


The exchange is also preparing for an expected surge in activity on the website through the coming weeks, especially in mid-December. The deadline to enroll in coverage is Dec. 15 for people who want their coverage to begin on Jan. 1, 2014, and the first premium payment is due Dec. 23.


“What we learned from October hopefully will better prepare us for December,” Onizuka said.




Feed You can follow this conversation by subscribing to the comment feed for this post.

Ziad Abdelnour

Obamacare critics fearful of the federal government controlling one-sixth of the nation's economy and the resulting loss of freedom have missed both the most serious threat to freedom and its likeliest victims. Obamacare stands to turn millions of our neighbors into criminals. That's because seeking a subsidy in order to obey the mandate of -- never mind afford -- the Affordable Care Act ("ACA," but referred universally as Obamacare)1 can easily put our most economically and educationally vulnerable fellow citizens on a path to jail. If this be compassion, it is true only in the same sense that euthanasia fulfills the definition

The comments to this entry are closed.