A government official estimated yesterday that 30 or 40 percent of Healthcare.gov still needs to be built:
Apparently, the accounting systems and payment systems that protect taxpayers against waste, fraud, and abuse—systems that also ensure that insurers get paid, and that premium subsidies are accurately doled out—have not yet been built.
It’s worth noting that, technically, you haven’t enrolled in a health insurance policy until the insurer has collected the first premium from the beneficiary. If the payment systems have not yet been built, it’s not clear how many people, then, have actually enrolled on the exchanges. Last week, the Obama administration claimed that 26,794 people had enrolled on the federal exchange, though HHS did not specify whether or not insurers had been paid.
How is this possible on November 19, when the Obamacare exchange was ostensibly launched on October 1?
Laszewski adds:
Healthcare.gov is not ready for what could come in just two weeks when, between December 1 and December 15, everyone expects massive pressure on the federal Obamacare enrollment and administration site so people can get coverage by January 1. My independent survey of health plans also matches comments by CMS Deputy Chief Information Officer Henry Chao [yesterday] at a House hearing that 30% to 40% of the IT systems needed to support Obamacare still must be built.
Sarah Kliff has more details:
The systems to send subsides to insurers haven’t been built. When someone does shop with a subsidy, the federal government is on the hook to pay part of their premium to the health insurance plan. Medicare deputy chief information officer Henry Chao testified before Congress today – and [Spokeswoman Julie] Bataille confirmed – that the system that will send those subsidies has not yet been created.
“My understanding of the system is we do not need that online until the middle of January, given how the payment schedule works,” she said. “It’s a back end system necessary to process information directly to issuers.”
In other words: Subsidies don’t start going out the door until 2014, so there is no need for the system to exist right now. Whether it exists in January 2014–that’s one area where we’ll have to wait and see.
The Dish 