A glitch on the federal health insurance marketplace has caused problems for about 18,000 West Virginians attempting to sign up for health coverage under the Affordable Care Act.
The federal exchange is having problems transferring account information to and from the state of West Virginia's system, Jeremiah Samples, assistant secretary for the state Department of Health and Human Resources, said Tuesday. The "account transfer" problem is not limited to West Virginia, though, he said.
"This really is a national problem," Samples said.
Of the 18,000 West Virginians 10,000 are people who used the Healthcare.gov website to sign up for coverage, but were determined to be eligible for Medicaid under West Virginia's expansion of that program.
Ideally, the federal website would have transferred accounts of those people on to the state, Samples said. Instead, the federal website is sending only "flat files," which have basic information about the person but not enough to sign them up for Medicaid, he said.
The DHHR is sending letters to those 10,000 people informing them they will need to sign up again via the state's Medicaid website (www.wvinroads.org) via the state's call center (888-483-0797) or at a county DHHR office, Samples said.
Another 8,000 West Virginians have been affected because they tried to sign up for Medicaid at a county DHHR office or via the state's Medicaid website but were found ineligible.
Their information was supposed to be transferred automatically to the federal health insurance exchange where they might be eligible for a subsidy on their health insurance plan. Now they must sign up again via Healthcare.gov if they want health insurance on the exchange.
The federal government will send an automated phone message to those 8,000 people to sign up again at Healthcare.gov or by calling the national call center, at 1-800-318-2596, Samples said. Helpers from the state Office of the Insurance Commission also will reach out to those 8,000, to help get them enrolled, he said.
Samples said, to avoid problems, individuals who make $15,414 or less annually should sign up for Medicaid via the state website or at a county DHHR office. Those who make more than that should go to the federal exchange to sign up, he said.
"If you go to the wrong place while it's being fixed, you'll receive notification that you do need to go back through the [other] system," Samples said.
He said he expects federal health officials to have the glitch fixed within the next month or so.
So far, about 82,000 people have signed up for Medicaid in West Virginia under expansion, Samples said. That does not include the 10,000 who are eligible but have not been enrolled because of the technical problems.
Under the Affordable Care Act, those people with incomes under 138 percent of the federal poverty line are eligible for Medicaid.
There are other problems between Healthcare.gov and the state's systems, Samples said.
The federal exchange determined at least one person to be eligible for Medicaid even though that person's income was too high to qualify, Samples said. There also have been a few cases where files from people who live outside the state have been transferred to West Virginia's Medicaid program, Samples said.
"West Virginia will not be accepting any inaccurate account transfers from the feds, even after the broader transfer issues are addressed," Samples said. "My hope and expectation is that, as the feds address these transfer issues, it will resolve what appear to be inaccuracies."
Perry Bryant, executive director of West Virginians for Affordable Health Care, he hopes the problem won't cause people to lose health coverage for a period of time.
"It's important to make sure there are not gaps in coverage because of a computer glitch," Bryant said. "The state and the feds need to work towards that."
At least with Medicaid recipients, there shouldn't be any coverage gaps, he said. When a person signs up for Medicaid, they can get up to the past three months of their previous medical care covered.
Bryant said he hopes Highmark Blue Cross Blue Shield would accept the first month's premiums for those 8,000 who didn't get properly enrolled yet via the federal exchange and start their health insurance coverage on Jan. 1.
"These people played by the rules and did everything right, and it was a computer glitch, a malfunction that created a gap in coverage," Bryant said. "That should not occur."
A spokeswoman for Highmark was not available for comment Tuesday.
(c)2014 The Charleston Gazette (Charleston, W.Va.)