January looked like a disaster in the making for the Affordable Care Act. From the stunted opening of Healthcare.gov on Oct. 1 through the end of December, 2.2 million Americans selected private health plans on the new marketplace (with policies starting on Jan. 1). Between spotty data files from the troubled website and last-minute deadline changes that let some people pay premiums after their policies started, people in the health-care world had braced for chaos when the newly insured showed up at doctors’ offices and pharmacy counters. “It’s going to be a messy January,” one insurance industry leader privately predicted.
That didn’t happen. While there were scattered, anecdotal reports of people having trouble accessing care, widespread problems haven’t materialized. “The month of January has been relatively quiet in our pharmacies in terms of any ACA-related issues,” Mike DeAngelis, a spokesman for CVS Caremark (CVS), wrote in an e-mail. The company operates more than 7,600 retail drug stores.
If there had been big problems, you would have heard about it. People unable to use Obamacare benefits would have joined those who couldn’t get on the website and those who had their old health plans canceled as the subjects of hundreds of news stories adding to the public’s increasingly negative view of the Affordable Care Act.
Compare the first weeks of Obamacare benefits with the Medicare drug benefit that started on Jan. 1, 2006. Two weeks in, President George W. Bush ordered insurers to pay for emergency supplies of prescription drugs to patients whose coverage couldn’t be verified at the pharmacy. States declared public health emergencies and shouldered the cost of drug claims while Medicare sorted out the mess. Bush didn’t mention the program in his State of the Union address that year.
Insurers, pharmacies, and doctors may have learned from that difficult transition and been better prepared for Obamacare problems. “Health plans have a lot of experience in implementing new reforms,” says Robert Zirkelbach, a spokesman for insurance industry group America’s Health Insurance Plans.
The problems with Healthcare.gov aren’t fully repaired.
Some enrollment files the site sends to insurance companies still have “missing and inaccurate information” that has to be corrected by hand, Zirkelbach says. “There’s the back-end technical problems that still exist. There’s systems that still haven’t been built.” Insurance companies have added staff and call centers to deal with the headaches.
Drugstore chains including CVS and Walgreen (WAG), as well as independent pharmacists, offered to renew prescriptions even if patients hadn’t gotten their new insurance cards yet. The problems that had surfaced at Walgreen are tapering off, according to spokesman Jim Cohn. While he declined to say how many cases of mix-ups Walgreen saw at its 8,200 pharmacies, Cohn wrote in an e-mail that “we’re beginning to see fewer inquiries and situations with people having difficulty accessing benefits as the systems and processes get into place.”
It’s normally not news when a government program performs as intended—reporters don’t cover all the flights that land safely—but after the rough first three months of Healthcare.gov, the disaster that didn’t happen in January is worth noting.
Source: BusinessWeek.com