13 Jul Thousands still lack PPACA coverage

Originally posted July 8, 2014 by Kathryn Mayer on www.benefitspro.com.

Just because consumers are paying for health care coverage though the exchanges under the Patient Protection and Affordable Care Act doesn’t mean they’re actually getting coverage.

According to a report from the Wall Street Journal on Tuesday, thousands of enrollees still lack coverage despite picking a plan and paying for coverage due to problems in the law’s enrollment systems. The problems are prevalent in California, Nevada and Massachusetts, states running their own exchanges. The enrollment glitches are causing thousands to delay care and pay more out-of-pocket expenses.

The newspaper’s report follows findings from the Health and Human Services inspector general last week that detailed widespread data errors still plaguing the law. That report found the administration was unable to resolve 2.6 million inconsistencies in the federal exchange out of a reported 2.9 million because the CMS system for determining eligibility was “not fully operational.”

And of the roughly 330,000 cases that could be straightened out, the administration only resolved about 10,000, which is less than 1 percent of the total.

The Wall Street Journal also reported that many enrollees who requested life event changes in coverage — such as marriage or a new child — haven’t gone into effect yet, even months are the request. For example, Minnesota has a 6,500 backlog for coverage change requests because of life events, the report found.

The Journal doesn’t pinpoint exact numbers, but it’s likely a fraction of the 8 million people who enrolled in coverage through the exchanges.

According to a report from the Commonwealth Fund, 20 million people have been covered because of the law — an additional 12 million people who gained coverage through other provisions of the law along with the 8 million who enrolled in coverage through the exchanges since the spring.