Published December 20, 2015
Having a baby in the new year? Good luck trying to enter that into HealthCare.gov.
In the latest glitch to emerge regarding the Affordable Care Act system, health officials are telling new enrollees that the federal insurance marketplace will not be able to update their coverage online to reflect the birth of a baby and other life changes.
Instead, parents are being told to contact insurers directly, and then contact the government later on -- when the system is ready to handle it.
Parents will still be able to get new babies covered, but the missing feature on the website represents another step, and just one of several glitches that continue to surface. In certain states, problems have also prevented thousands of would-be Medicaid enrollees from getting coverage.
The function that prevents people from entering in a newborn pertains to the computerized "change in circumstance" feature. It was supposed to have been part of the federal system from the start.
But that feature got postponed as the government scrambled to fix technical problems that overwhelmed the health care website during its first couple of months.
"It's just another example of `We'll fix that later,"' said Bob Laszewski, an industry consultant who said he's gotten complaints from several insurer clients. "This needed to be done well before January. It's sort of a fly-by-night approach."
"We are currently working with insurers to find ways to make changing coverage easier while we develop an automated way for consumers to update their coverage directly," responded an administration spokesman, Aaron Albright.
It's not just having a new baby that could create bureaucratic hassles, but other life changes affecting a consumer's taxpayer-subsidized premiums.
The list includes marriage and divorce, a death in the family, a new job or a change in income, even moving to a different community.
Such changes affect financial assistance available under the law, so the government has to be brought into the loop.
A Dec. 31 circular from the Centers for Medicare and Medicaid Services addressed the problem.
In questions and answers for insurers, the government said that the federal insurance marketplace will not be able to add a child until the system's automated features become "available later." It does not provide any clue as to when that might take place.
The federal marketplace serves 36 states through HealthCare.gov and call centers. The Medicare agency, which runs the government's other major health programs, is also responsible for expanded coverage under Obama's law.
The question-and-answer circular says parents with a new baby will be told to contact their insurer directly "to include the child immediately" on their existing policy.
After the federal system is ready to process changes, parents will have to contact the government to formally bring their records up to date. Albright said parents will be able to add a new child to their policy for 30 days.
Having a baby could increase a family's monthly premiums, but it could also mean that the parents are eligible for a bigger tax credit to help with the cost. Under some circumstances, it could make the child or the family eligible for Medicaid, a safety-net program that is virtually free of cost to low-income beneficiaries.
At least 2 million people have signed up for private health policies through new government markets under President Barack Obama's overhaul. Coverage started Wednesday, and so far things appear to be running fairly smoothly, although it may take time for problems to bubble up. Health and Human Services Secretary Kathleen Sebelius calls it "a new day in health care" for millions of Americans.
But another problem, with Medicaid, was surfacing after the launch. In West Virginia, The Charleston Gazette reports that a glitch caused problems for 18,000 people trying to sign up for coverage.
Of them, 10,000 tried to go through HealthCare.gov but were told they qualified for Medicaid. However, the website reportedly transferred basic files to state officials -- lacking information needed to sign them up for the government program.
Now, state officials are sending those individuals letters telling them to sign up again via the state's Medicaid site. The other 8,000 reportedly tried to sign up for Medicaid through the state, and were told they were ineligible -- however, the information was not transferred to the federal exchanges, as it was supposed to be.
Those individuals, too, are being told to try again to sign up at HealthCare.gov.
Perry Bryant, director of West Virginians for Affordable Health Care, told the newspaper that "these people played by the rules" and, because of a glitch, now have a "gap in coverage."
Iowa officials recently reported a similar problem.
The Associated Press contributed to this report.