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ObamaCare Clusterfuck: Appeals process not in place, but when it is, it's going to be automated

As we've said many times, ObamaCare is a needlessly* complex system that throws people into buckets depending on their income, age, jurisdiction, employer, and the characteristics of their family, among other things. Inevitably, people get tossed into the wrong bucket. One would naturally have expected an appeals process to be in place to help people who are unjustly treated. No such luck:

HealthCare.gov can’t handle appeals of enrollment errors
Tens of thousands of people who discovered that HealthCare.gov made mistakes as they were signing up for a health plan are confronting a new roadblock: The government cannot yet fix the errors.

Roughly 22,000 Americans have filed appeals with the government to try to get mistakes corrected, according to internal government data obtained by The Washington Post. They contend that the computer system for the new federal online marketplace charged them too much for health insurance, steered them into the wrong insurance program or denied them coverage entirely.
ect.

For now, the appeals are sitting, untouched, inside a government computer. And an unknown number of consumers who are trying to get help through less formal means — by calling the health-care marketplace directly — are told that HealthCare.gov’s computer system is not yet allowing federal workers to go into enrollment records and change them, according to individuals inside and outside the government who are familiar with the situation.

Lovely. Following WaPo's reporting, the White House rushed to handle the PR problem. Reuters:

U.S. says HealthCare.gov enrollment appeal hearings to begin soon
The U.S. Centers for Medicare and Medicaid Services (CMS), the lead agency responsible for implementing the healthcare reform law, issued a statement saying it was reaching out to consumers with error-ridden enrollments to help them complete applications for coverage without a formal appeal.

Oh, they couldn't do that before? Do these people actually give a shit?

The statement came in response to a Washington Post report that said about 22,000 Americans have appealed to CMS for help fixing enrollment mistakes that have led to excessive charges, enrolled them in the wrong health plan, or denied them coverage altogether.

The appeals have hit a technological dead end, the newspaper reported, because the administration has yet to complete the technology infrastructure necessary to manage the appeals process.

"CMS is working to fully implement an automated appeals system. Until we have that functionality, we are putting in place a manual review process wherever possible and expect hearings to begin soon," said the agency.

Jesus fucking Christ. An appeals system where you never reach a human? An appeals system that works like an automated phone menu? What's wrong with these people?

NOTE * Needless because single payer, a proven system tested in Canada, doesn't throw anybody into buckets. "Everybody in, nobody out."

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DailyPUMA's picture
Submitted by DailyPUMA on

I think what's happening is our business community has become so addicted to adhesion agreements that when the government tries to emulate what the business community does, they also do adhesion agreements.

This is somewhat ironic because Government actually may have more people in place to actually handle complaints than the business community does.