Arrow-right Camera


Thousands still can’t use health plan

SEATTLE – Seven months after major glitches in the Washington health exchange were discovered, authorities acknowledge that thousands of state residents still don’t have insurance they can use to go to the doctor or fill a prescription.

Although some problems have been resolved during the past few weeks, new issues also have come to light in Washington’s implementation of the federal health care overhaul.

Insurance companies and the state insurance commissioner are concerned the total number of people who bought insurance through the exchange and are now having billing problems could be many more than the 6,000 customers identified by the exchange a few weeks ago.

“I know we’re only looking at a small portion of the problems,” said state Insurance Commissioner Mike Kreidler. His office does not have authority over the exchange but that hasn’t stopped consumers from calling him to complain.

Some people aren’t being properly credited by the exchange for their insurance payments. In some cases, money and information has been lost somewhere between the exchange and the insurance companies. And some people have been told by their doctors that the insurance company has no record of their coverage.

Kreidler said he’s giving the exchange a month to fix the problems or he will take what action he can to help the people of Washington who want health insurance.

“I’ve got my fingers crossed” the problems will be resolved this month, he added. If not, he will open a special enrollment period for anyone who wants to give up on the exchange and buy insurance outside of the new system through brokers and insurance agents.

Hundreds of known problems are being resolved every day, said exchange spokesman Michael Marchand. He estimates 4 to 6 percent of the 164,000 who bought insurance through the exchange have been affected by billing problems.

An average of 2,500 accounts have had their problems solved each month, according to the exchange.

But people who purchased insurance through Washington Healthplanfinder but haven’t been to the doctor might not know they have a problem, an insurance company spokeswoman said this week.

Melanie Coon of Premera Blue Cross, which has sold more policies on the exchange than any other insurance company in the state, could not say exactly how many of Premera’s customers are having problems.

She advised people who have any questions about their insurance status to call the company and check.

If there is a problem, however, Premera might not be able to fix it.

“I don’t want to create an unrealistic expectation that we can resolve their problem,” she said.

Most problems need to be fixed at the insurance exchange.


There are four comments on this story »