Obama administration developing automated system to measure payments for Obamacare coverage
February 13th, 2014
09:58 AM ET
7 months ago

Obama administration developing automated system to measure payments for Obamacare coverage

Washington (CNN)  - It's one data point Obama administration officials have yet to disclose: just how many new Obamacare enrollees have actually paid their premiums.

As the Obama administration released its latest enrollment figures Wednesday, officials broke down some of the demographics on consumers who are signing up for coverage. But White House officials have so far not provided data on how many people have sent in their payments to activate their plans.

Asked for that information Wednesday, White House Press Secretary Jay Carney pointed to the insurance companies as the best source for that metric.

"It is a contract between an individual or - well, an individual even representing his or her family - and a private insurance provider. So insurance companies obviously have data about when those payments are made," Carney told reporters at Wednesday's press briefing.

An insurance industry source with knowledge of the roll-out of the Affordable Care Act estimates that anywhere from 10%-25% of people have not paid their premiums, meaning their enrollment was likely canceled.

The industry official said the administration is collecting data on premium payments. "(Insurance) plans have to report (payment data) to HHS because that determines the subsidy payments. The government will not subsidize coverage for someone who never paid and is not actually enrolled," the insurance industry official said.

But a senior administration official told CNN the payment data is not quite ready to be made public.  That's because the Center for Medicare and Medicaid Services is currently developing an automated system that will eventually track and measure payment data, based on the "834" enrollment forms that are submitted to insurance companies as consumers sign-up for coverage and apply for financial assistance.

"Some health plans, but not all, have begun providing individual effectuated 834 transaction forms, which will eventually be the mechanism for making payment and reporting enrollment data as part of our automated system," the senior official said.

"We anticipate this reporting of effectuated 834 transaction forms to increase over time as CMS' automated functionality comes online," the official added.

Republican critics of the Affordable Care Act maintain the administration's enrollment data is incomplete until it includes payment information to clarify just how many Americans are signing up for coverage.

Last month CNN Money reported the insurance companies were finding varying degrees of success in collecting payments from customers.

Until its automated enrollment and payment tracking system is in place, the Obama administration is collecting some raw payment data based on what insurers and some state-based Marketplaces are submitting to CMS.

"Once our automated payment systems are completed and fully tested, we will determine the most appropriate way to make detailed payment information available," an administration official said.


Filed under: Healthcare • Obamacare
soundoff (42 Responses)
  1. xray vision

    Pretty sure I'm not eligible at my income, the insurance rates go up every year, and coverage went down every year. Then the next year the plan changes, deductible goes up, coverage down, year after year, I've been at this a while. Certain I said no subsidies, but that's not what you wanted to hear so I must be wrong, grow up already.

    February 13, 2014 12:08 pm at 12:08 pm |
  2. countingdown

    Silence DoGood, Dutch/Bad Newz, VA -aka- Where's Our $24 Billion?,
    Snifit

    Equality has never and will never be achieved! Socialism, is NOT what the Constitution provides! Why do each of you want it? If obamacare is SO GREAT why do you and all democrats and the president cry about what we conservatives think. Its is law, so all should be wonderful! IT IS NOT, YOU KNOW IT, I KNOW IT, AMERICA KNOWS IT, AND IF WILL BE CORRECTED

    February 13, 2014 12:08 pm at 12:08 pm |
  3. Silence DoGood

    @Alex
    Anonymous: Maybe you should ask the millions of Americans who couldn't afford healthcare, and the thousands who went bankrupt, lost their houses, everything they had, because of soaring healthcare costs, if it was a "simple economic decision." Before Obamacare, the only ones making decisions for healthcare were the insurance companies. And no surprise those decisions had everything to do with profit and nothing to do with quality affordable healthcare.

    Every single problem that is coming to light because of Obamacare can be directly traced to problems that have always existed, and continue to exist, with the for-profit health insurance industry.
    -----------–
    Brilliant. Thanks. They ignore the people hurting before this. The new conservative motto: " I got mine, the rest of you go sucks rocks."

    February 13, 2014 12:10 pm at 12:10 pm |
  4. Sniffit

    "SOCIALISM! Look up the definition!"

    As I said, if you're having trouble with accepting that taxation is a power provided for therein, and just something something "lalalalalalalala I can't here you I can't here you I can't here you I can't here you I can't here you I can't here you I can't here you " don't want to accept that taxation is, by definition, a method of "wealth redistribution" or "wealth sharing" then I can't help you...and your inability to think straight is not my problem.

    February 13, 2014 12:13 pm at 12:13 pm |
  5. Dutch/Bad Newz, VA -aka- Where's Our $24 Billion?

    Fair is Fair
    Dutch/Bad Newz, VA -aka- Where's Our $24 Billion?

    "What's wrong with that, is its not like car insurance, if I don't own a car I don't have to buy car insurance!"
    ----–
    But if you walk into an emergency room uninsured, those costs go to those who are insured. So therefore, everyone must have skin in the game.
    ---
    What "skin in the game" does a Medicaid recipient have? They pay zero, zip, nada, bupkiss... yet the liberal mantra is that there wasn't ENOUGH Medicaid expansion. So do tell, Dutch...
    ---------------------------------------–
    Maybe they wouldn't have to be on Medicaid if they were making liveable wages. See how this welfare & economic fairness thing works? If employers paid their employees reasonable wages, many people could get off government assistance. It's really that simple.

    February 13, 2014 12:15 pm at 12:15 pm |
  6. Fair is Fair

    ghostwriter

    You have got to just love conservatives. They complain about having to pay for other's healthcare.....and yet the biggest cause of insurance premiums rising is that hospitals overcharge for those who can't pay otherwise.

    So they hate Obamacare because it forces them to pay less now as opposed to paying more later. Rather, they hate Obamacare because they are trained to hate Obama.
    ---------
    Respectfully disagree. Perhaps the biggest culprit is the waste, fraud, and abuse. What you describe is "cost-shifting" and while it does exist to cover the uninsured, it's far more prevalent to cover the losses incurred by providers forced to accept below-market reimbursements from Medicare and Medicaid.

    February 13, 2014 12:21 pm at 12:21 pm |
  7. Dutch/Bad Newz, VA -aka- Where's Our $24 Billion?

    countingdown
    Silence DoGood, Dutch/Bad Newz, VA -aka- Where's Our $24 Billion?,
    Snifit

    Equality has never and will never be achieved! Socialism, is NOT what the Constitution provides! Why do each of you want it? If obamacare is SO GREAT why do you and all democrats and the president cry about what we conservatives think. Its is law, so all should be wonderful! IT IS NOT, YOU KNOW IT, I KNOW IT, AMERICA KNOWS IT, AND IF WILL BE CORRECTED
    ---------------------------------–
    First things first: Spell check! Now as far as socialism goes, if you are so against, tell that to every republican, democrat & independent on Medicare.

    February 13, 2014 12:23 pm at 12:23 pm |
  8. Fair is Fair

    Dutch/Bad Newz, VA -aka- Where's Our $24 Billion?

    Fair is Fair
    Dutch/Bad Newz, VA -aka- Where's Our $24 Billion?

    "What's wrong with that, is its not like car insurance, if I don't own a car I don't have to buy car insurance!"
    --–
    But if you walk into an emergency room uninsured, those costs go to those who are insured. So therefore, everyone must have skin in the game.
    -
    What "skin in the game" does a Medicaid recipient have? They pay zero, zip, nada, bupkiss... yet the liberal mantra is that there wasn't ENOUGH Medicaid expansion. So do tell, Dutch...
    -------------–
    Maybe they wouldn't have to be on Medicaid if they were making liveable wages. See how this welfare & economic fairness thing works? If employers paid their employees reasonable wages, many people could get off government assistance. It's really that simple.
    --------
    That is nothing but a deflection on your part. But I'll play... define what you consider a "reasonable wage". Does it vary from state to state, region to region, job to job? Enlighten me... I'm more than willing to listen. But be specific.

    February 13, 2014 12:26 pm at 12:26 pm |
  9. Silence DoGood

    @countingdown
    Silence DoGood, Dutch/Bad Newz, VA -aka- Where's Our $24 Billion?,
    Snifit

    Equality has never and will never be achieved! Socialism, is NOT what the Constitution provides! Why do each of you want it? If obamacare is SO GREAT why do you and all democrats and the president cry about what we conservatives think. Its is law, so all should be wonderful! IT IS NOT, YOU KNOW IT, I KNOW IT, AMERICA KNOWS IT, AND IF WILL BE CORRECTED
    --------–
    I was not talking about equality. I was talking about the denial of opportunity. Insurance companies were denying millions the opportunity to buy insurance. – that is not the free market. Before ObamaCare, many people were told, you cannot buy ANY insurance or you are being FORCED off your policy.

    The debate between strong central government and local/state governments has gone on since George Washington. You are confusing debate in a democratic republic with Socialism straw-man.

    February 13, 2014 12:31 pm at 12:31 pm |
  10. just saying

    Silence DoGood
    The way insurance works is to distributes costs to others.
    --

    correct, costs, but obamacare has changed this to something else, a wealth redistribution system.

    young people are paying amounts that are three times higher than justified for their age group because they are paying for the artificially low rates of others. that is a obamacare government mandated ripoff of the young.

    February 13, 2014 12:37 pm at 12:37 pm |
  11. Obamacare - Family Future Redistribution

    More of my money is being taken to give to others. Now MY family must do without or do with less. I am not on this earth to supply food to the entire hive. I must take care of myself and my family before I can start to shoulder the burden of others. Obamacare is stealing my family's future.

    February 13, 2014 12:41 pm at 12:41 pm |
  12. Sniffit

    "What "skin in the game" does a Medicaid recipient have?"

    None. But that's because they've already been flayed by our country's economic policies.

    February 13, 2014 12:43 pm at 12:43 pm |
  13. countingdown

    Whatever on my spelling to you liberals there is only one option!
    Provide free healthcare to a Americans.
    Provide free food to all Americans.
    Provide free education as long as you want to all Americans.
    Provide free homes to all Americans.
    Provide free utilities to all Americans.
    Provide free home furnishings to all Americans.
    Provide free electronic devices to all Americans.
    Provide free car and car insurance to all Americans.
    I'm sure that's not all you want but maybe this will help.
    Take the earnings and savings of all Americans, and divide by the total persons alive in America at the end of each year

    February 13, 2014 12:43 pm at 12:43 pm |
  14. countingdown

    Complete last post accidentally hit post

    Then redistribute. I'm sure that would work for you!

    February 13, 2014 12:45 pm at 12:45 pm |
  15. Silence DoGood

    @just saying
    Silence DoGood
    The way insurance works is to distributes costs to others.
    -

    correct, costs, but obamacare has changed this to something else, a wealth redistribution system.

    young people are paying amounts that are three times higher than justified for their age group because they are paying for the artificially low rates of others. that is a obamacare government mandated ripoff of the young.
    -----------
    I hear what you are saying but this is better than millions being told they are not allowed to buy or continue insurance at all, at any price, with their own money.

    February 13, 2014 12:48 pm at 12:48 pm |
  16. Dutch/Bad Newz, VA -aka- Where's Our $24 Billion?

    That is nothing but a deflection on your part. But I'll play... define what you consider a "reasonable wage". Does it vary from state to state, region to region, job to job? Enlighten me... I'm more than willing to listen. But be specific.
    ---------------------------------------–
    A "reasonable wage" in my book is a wage that keeps up with inflation and the cost of living in that region. Specific enough?

    February 13, 2014 12:49 pm at 12:49 pm |
  17. Wake up People!

    Damn counting down, where does one sign up for all of those freebies?? Free car and car insurance? Count me in!

    But seriously, not all liberals want EVERYTHING to be free.

    February 13, 2014 12:58 pm at 12:58 pm |
1 2