The latest tweak reveals how much of the health law's basic architecture is still incomplete.
October, when it became clear that Obamacare's online enrollment system wasn't functioning, President Obama gave a speech in which he told people who wanted to sign up to contact call centers instead, or fill out pen and paper applications.
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This week, the administration announced that it would be employing another manual workaround, this time for critical insurer payment systems. In this case, it's not because the payment system is broken. Instead, it’s because the part of the system that is supposed to both calculate how much money the government owes insurers in premium subsidy and cost-sharing payments and make the appropriate payments simply hasn't been built yet.
What hasn't been built can’t be used, but insurers need to be paid in order for the system to function. So the administration has decided to require insurers to estimate how much they are owed and submit payment requests manually. Later, after the systems are built, the plan is to sort out the details and figure out the exact amounts that should have been billed, then reconcile any differences.
Because it deals with the insurance industry side of the system, this temporary, technical tweak will probably garner far less attention than the ongoing problems with the consumer side of the federal exchange system. But the on-the-fly patch offers a revealing moment for the law all the same, one that highlights how unfinished, unaccountable, and unworkable the health law continues to be.
On the most basic level, the newly proposed patch suggests how much work remains on simply constructing the essential technical infrastructure necessary to make Obamacare's exchange-based insurance scheme work. Some 30 to 40 percent of the functionality remains incomplete, according to Henry Chao, the Medicare technology official who oversaw the development of the exchanges. And the features that remain to be built are vital to the system’s functionality.
The core service that health insurers provide is paying for eligible claims by beneficiaries. But if insurers don't get paid themselves, they can’t cut checks for those claims. Some of the larger insurers could finance delays, at least for a little while, but as former Medicare official Kevin Lucia tells Reuters, smaller insurance plans, which are heavily represented in the health law’s exchanges, aren't well equipped to do so. Plan providers need that money, and they need it soon if they're going to be able to actually provide insurance to their plan members.
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