WASHINGTON – Republicans in Congress are pressing the Obama administration for answers about why officials are proposing to penalize states for significant backlogs of Medicaid applications, which have been delayed by the technology challenges of the Healthcare.gov website.
Many state social service agency workers have been forced to complete Medicaid applications by hand, which is causing long delays for vulnerable populations receiving benefits.
In a new letter to Marilyn Tavenner, chief of the Centers for Medicare & Medicaid Services, Rep. Fred Upton, R-Mich.; Sen. Orrin Hatch, R-Utah; and Sen. Lamar Alexander, R-Tenn., reference an April 10, 2014, Senate Finance Committee hearing where Health and Human Services Secretary Kathleen Sebelius was asked about the growing backlog.
“We believe it would be inappropriate for CMS to reduce payments to states that may be experiencing a backlog of applications due to the Healthcare.gov website. Such an approach would violate the very nature of a federal-state partnership,” congressional leaders wrote.
“Secretary Sebelius’ response seems to suggest that Centers for Medicare and Medicaid Services, or CMS, may be in the process of pursuing punitive payment actions against states in spite of – and perhaps even due to – their good-faith efforts to cope with information technology problems resulting from HealthCare.gov,” congressional leaders wrote.
They noted that under Obamacare, the enrollment for Medicaid is expected to surge suddenly by 13 million beneficiaries. The federal spending is projected to explode from $265 billion in 2013 to $554 billion in 2023.
As WND reported last year, the site is riddled with security glitches. One month before the disastrous launch of Healthcare.gov, a program that on its first day allowed a single person to sign up, a government memo warned of a “limitless” security threat that would expose insurance buyers to identity theft.
It was at an April 10 Senate Finance Committee Hearing where Sebelius reported an untold number of Medicaid applicants are stuck in states that did not install computer programs capable of transferring data to the federal government’s automated system, as the law intended.
“We are actually kind of ramping up the pressure on states and will look at some potentially administrative reductions in payment if people don’t pick up this pace,” Sebelius said at the hearing, without providing details.
Sebelius said traffic on HealthCare.gov, the federal health care enrollment website for consumers in 36 states, was 4.8 million visitors on March 31. A federal call center received two million calls on that day. Fourteen state-run marketplaces also experienced a surge and are expected to add to the federal data.
Republicans have criticized the government for not providing more detailed data on how many people have actually completed enrollment by paying their first month’s premium. Individual insurers have estimated that number at 80 percent to 85 percent of their new members.
“It’s like Amazon.com taking stock of how many people have placed items in their shopping carts and then counting them as sales. In other words, it’s a false metric,” Hatch said.
Sebelius acknowledged there are extensive backlogs of people in some states who have applied for Medicaid but remain unable to access care because of various computer system delays.
The Medicaid issue was raised by Sen. Robert Menendez, D-N.J., who said a single county in his home state of New Jersey is reported to have a backlog of 10,000 applications and only six state workers to process the applications by hand. New Jersey is among the states that expanded Medicaid.
“It would take nearly a year and a half to clear the backlog,” Menendez said.
The GOP members, however, said more information is needed. They asked whether CMS is pursuing penalties for states with backlogs, whether those penalties include payment reductions, and whether those punitive actions would apply to all states, or not.
Also, what are the parameters for imposing a penalty, they are asking.