Sunday, October 27, 2013

Promised Fix for Health Site Could Squeeze Some Users

To help meet that schedule, the Obama administration, in an abrupt shift, named a “general contractor” on Friday to oversee changes to the troubled Web site of the federal marketplace.

Such a condensed time frame raises the question of how hundreds of thousands of people whose current policies do not comply with the health law will obtain new coverage in time, and how millions who may qualify for subsidies will enroll. Some experts predicted a groundswell of demands from Congress and elsewhere to delay the deadlines.

Jeffrey D. Zients, President Obama’s troubleshooter on the project, said the general contractor, Quality Software Services Inc., a unit of the UnitedHealth Group, would now “manage the overall effort,” like a general contractor on a home improvement project. Notably, that company had a role in developing one of the most troubled components of the marketplace, which helped verify the identities of those registering.

Until now, the federal Centers for Medicare and Medicaid Services served as the project’s quarterback. Contractors complained that the agency did not have the expertise to lead such a complex and ambitious undertaking, requiring the integration of dozens of programs and databases.

People involved in the repair effort said the Nov. 30 deadline was challenging but not impossible to meet. Mr. Zients, a management expert who is in line to take over as the chief White House economic adviser on Jan. 1, said, “By the end of November, will work smoothly for the vast majority of users.”

“It will take a lot of work,” he said. “A lot of problems need to be addressed. But let me be clear: is fixable.”

Since it went live on Oct. 1, the Web site has frustrated millions of people trying to obtain insurance under Mr. Obama’s health care law. For the administration, making it work is increasingly urgent for both political and practical reasons.

In recent weeks, insurance companies have notified hundreds of thousands of people around the country that their current coverage will end on Dec. 31 because it does not comply with the Affordable Care Act. For example, the policies may not provide “essential health benefits” like maternity care and may not cover as much of the medical costs as required by new federal standards.

In a typical letter, about 25,000 policyholders of Independence Blue Cross in Pennsylvania were informed, “As a result of the health care law, your current health plan will be discontinued effective December 31, 2013.”

Consumers living in Washington, D.C., were informed by CareFirst BlueCross BlueShield that “your current plan will cease to exist” on Jan. 1 because it does not conform to the new federal mandates.

Blue Cross and Blue Shield of Florida said it was informing about 300,000 subscribers that their insurance policies did not meet the new requirements.

Consumers are typically offered new coverage that meets federal standards, but the cost of comparable policies may be more or less than what they now pay, depending on a person’s age, income, family size, place of residence and tobacco use, among other factors.

Millions of consumers with individual policies are expected to qualify for subsidized rates. But the government must calculate the correct subsidies and process the enrollments — functions that were to be handled mainly by the Web site. People can also file applications on paper or by phone.

More than 19 million people have visited the Web site in the three and a half weeks since it opened as the main online vehicle in 36 states for choosing insurance coverage. But insurance executives said they were still receiving incomplete and inaccurate data on those who manage to get through the application process.

Mr. Zients said more than ninety percent of users were now able to create accounts, but only three out of ten were “getting through the application process.”

Robert Pear reported from Washington, and Sharon LaFraniere from New York. Ian Austen contributed reporting from Ottawa, and Reed Abelson from New York.

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