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Friday, December 20, 2013

Editorial: The Obamacare 10 Percent Club

Attention, last-minute insurance shoppers: There are only four days before P-Day, Dec. 23. That's the deadline for choosing a plan on an Obamacare insurance exchange to ensure that coverage begins on Jan. 1.

If you're scrambling to make last-minute arrangements, or waiting to hear if your insurer has actually received and approved your application, we know this is not your fault. For weeks, the government's website repelled customers with the brutal efficiency of a nightclub bouncer. Even if you thoughtyou completed the process, chances were good that your application information wasn't accurately sent to insurers.

If you're among the millions who had their individual policies canceled because of Obamacare, you may still be confused about the conditions under which your insurer will extend those policies and at what cost.

Last week, federal officials piled on more confusion when they urged insurers to relax coverage rules. The feds asked companies to cover people even if they miss theJan. 1 deadline to pay their premium. On Wednesday, most insurers agreed to grant customers a grace period until Jan. 10 to pay premiums. The feds also pushed insurers to refill prescriptions in January, even if those pills aren't covered under the new plan. And they prodded insurers to treat out-of-network doctors as in-network under some emergency circumstances. Our analysis: Huh?

You think the Obamacare run-up to Jan. 1 has been a train wreck? Now it gets worse.

You'll soon be hearing more stories of people who thought they'd signed up for coverage, only to find that their paperwork was gobbled by computer gremlins. U.S. Department of Health and Human Services officials said they've whittled down the error rate in enrollment data sent to insurers from an astronomical 1 in 10 to "close to zero."

But insurers say they are still finding errors and the government is overstating improvements to, The New York Times reported. In some cases, for instance, the home address for a new policy holder was outside the insurer's service area. Or a child was listed as the main subscriber — the person on the hook for premiums — with parents listed as dependents. Or people were listed two or three times on an application, which could mean higher premium payments.

Looming question: How many people have gained coverage versus those who have lost it? No one knows — yet. HHS is fond of boasting of rising numbers of people who have signed up for coverage, but officials don't keep track of how many have paid premiums to start coverage.

One thing is certain: Most states lag behind in their Obamacare sign-up goals. The National Review Online reported this week that 45 states haven't yet hit 10 percent — 10! — of their enrollment goals. In Illinois, a paltry 7,043 people have signed up, hardly a dent in the state's goal of 300,000 by the end of March.

Just as important: Who's signing up? Insurers need droves of young healthy people to pay premiums that offset all the money pouring out to cover older, sicker people. The administration hopes that 4 in 10 new enrollees will be age 18 to 34. Preliminary numbers don't look promising. In some states, a paltry 1 out of 5 new enrollees fall in that age range.

Many young, healthy people aren't buying the Obamacare pitch, according to a recent Harvard University Institute of Politics poll. Of respondents who were not insured, more than 1 in 4 said they would definitely or probably not enroll. About the same number said they would. The rest were on the fence.

Ominous development for Obamacare's future: The survey found that only 18 percent of those young people polled believe their quality of health care will improve under Obamacare while 40 percent believe it will grow worse. Another body blow: By a ratio of 5 to 1, those polled believe their costs will increase.

Many of those young people who don't enroll will pay mild penalties rather than steep premiums and deductibles. Perfectly legal. And perfectly lethal for Obamacare: Premiums rise, more people bail, subsidies soak taxpayers and the whole system tilts into insolvency.

But that comes later. For now, "the big moment of truth is 12 a.m. Jan 1, when a mother is standing at a pharmacy with a baby in her arms trying to get a script filled," Aetna Inc. CEO Mark Bertolini told The Wall Street Journal.

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