Washington health insurance exchange overpays subsidies

SEATTLE – Officials with Washington’s new health exchange announced Friday that 8,000 insurance applicants erroneously qualified for higher tax credits because of a system error.

Richard Onizuka, CEO for the Washington Health Benefit Exchange, said the system error was uncovered and corrected this week. The problem was traced to an inconsistency in file formats shared between the Washington Health Plan Finder website and federal data.

Onizuka said the error “caused applicants to qualify for higher-than-expected tax credit amounts than allowed based on their income level or household size.”

“The Exchange is very disappointed to have discovered this issue and we find the situation unacceptable,” he said in a statement. “Our staff will not stop working until we have notified all those affected and helped each and every one of our customers ensure they have the correct tax credit amount and can choose the best plan to meet their needs and budget.”

Health exchange officials said they are notifying the affected applicants. Exchange spokeswoman Bethany Frey said that of the 8,000 affected, 3,400 were completely enrolled and had submitted payment, but that those payments had not been processed. The rest had completed their applications but had not submitted payment.

The error is the largest acknowledged since the Web-based application’s shaky launch at the beginning of the month. Although the site hasn’t left all its errors and glitches behind, thousands are signing up for health insurance each week and the program has moved from startup to maintenance, said Michael Marchand, spokesman for the Washington Health Benefit Exchange, which runs the website, a call center in Spokane Valley and outreach efforts across the state.

Marchand summarized the biggest problems keeping people from using the website during its first days of operation as:

• Communication problems between the state site and the federal government.

• Choke points where a lot of data was being uploaded by a lot of people at the same time.

• People entering the wrong kind of information or in the wrong format or using characters the program couldn’t read, such as ampersands.

Some of those issues were fixed in the first few days; others have required an ongoing process of responding to error reports, complaints to the call center and comments on social media, Marchand said. Helpful hints also have been embedded into the site now, reminding users to do certain things.

Volumes at the call center have been many times greater than expected, in part because of all the error messages on the website. The call center, where people can ask for help or can set up their account and shop for insurance with help from a real person, was staffed to answer about 2,500 calls a day, but has received an average of 6,000 calls a day, and up to 10,000 on some days.

The exchange is hiring about 80 additional call center workers to decrease wait times, as call volume is expected to remain high through December.

About 35,000 Washington residents have signed up for insurance through the exchange since it opened Oct. 1. Another 56,000 people have completed online applications for insurance but won’t officially be signed up until they pay the insurance company. Those payments are due in December for coverage beginning in January.

Another 20,000 have created an account on the website but have not signed up for insurance. Nearly 300,000 more have taken a look at the site but haven’t registered.

Before health care reform went into effect, an estimated 1 million Washington residents did not have health insurance.