Republicans Grill Sebelius on Unanswered Obamacare Questions
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The Fiscal Times
March 12, 2014

Republicans slammed Health and Human Services Secretary Kathleen Sebelius on Wednesday for not providing answers to a lingering question most crucial to understanding how the Affordable Care Act is working so far.

How many people are actually getting coverage through Obamacare?

The administration released the latest enrollment figures on Tuesday—revealing that some 4.2 million Americans have signed up for coverage on the new exchanges. However, that figure does not include how many people have actually paid for their plans—a metric that could make the actual number of enrollees significantly lower.

Related: 3 Questions We Need to Know About Obamacare

Republicans have jumped on this point and are criticizing the administration for failing to provide vital information about the law.

“How can it be that the agency overseeing Obamacare cites an enrollment number and has no idea how many people have paid?” Rep. Tom Price (R-GA) asked Sebelius at a congressional hearing on Wednesday.

Price cited a recent survey by the consulting firm McKinsey that found about 25 percent of Obamacare enrollees have not paid for their plans.

Though Sebelius did not confirm this number, if accurate, it could mean that enrollments would be around 3.1 million --even further from the White House’s original goal of signing up 7 million people in the new exchanges this year.

Related: Obamacare Enrollment Slows Ahead of Deadline

McKinsey’s estimates are in line with other surveys of insurers that have reported receiving payments from about 75 to 80 percent of enrollees.

Still, Republicans say the administration should be collecting this information.

“We’re two weeks away from open enrollment and HHS has spent $2 billion building these exchanges,” House Ways and Means Committee Chairman Dave Camp (R-MI) said. “Given all the time and critical need your department has for this information I think it’s absolutely critical that we get this information.”

Sebelius explained that her department does not have that information right now and suggested lawmakers look to insurance companies for that answer instead.

Related: Why There May Be A New Obamacare Delay

“This is not Medicare or Medicaid sir, it’s a private plan. People are buying a product in the private market,” Sebelius said. “Consumers don’t pay us, they pay their insurance company, we don’t have that information right now.”

However, she said that HHS will eventually be collecting the data when a portion of the back-end of the website is complete. Right now, a function of the site that relays information from insurers to the federal government is still being re-built after a technical problems plagued the website last year. When it is complete, insurance companies will send verification to the government detailing which enrollees have paid their premiums.

“We will when we have the fully automated financial system in place, but we don’t have it right now.” she explained. She did not explain why HHS did not require insurers to report their pay up results on a regular basis.

Related: Obamacare Fixes Hide a Big Mess on the Back End

The function needed to supply this information to HHS is called the “834 transaction”—which was one of the major pieces of the website that failed during the nightmarish launch in October. CMS officials who gave weekly updates of the website’s repair efforts often cited fixing the “834 transactions” as their top priority.

Though it’s not certain, it is likely that had the website not suffered from technical problems, HHS would have this critical information.

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Washington Correspondent Brianna Ehley, based in D.C., covers Congress, government agencies and spending issues, health care, and tax and economic policy for The Fiscal Times.