Insurers Seek to Bypass HealthCare.Gov Despite 'Dramatic Progress'

December 2, 2013

Insurers and some states are continuing to look for ways to bypass the balky technology underpinning the health-care law despite the Obama administration's claim Sunday that it had made "dramatic progress" in fixing the federal insurance website.

Federal officials said they had largely succeeded in repairing parts of the site that had most snarled users in the two months since its troubled launch, but acknowledged they only had begun to make headway on the biggest underlying problems: the system's ability to verify users' identities and accurately transmit enrollment data to insurers.

One of the leading states operating its own exchange is considering ways to decouple itself from the federal infrastructure it relies on to confirm residents' eligibility for federal tax credits. That technology has been affected by planned and unplanned outages.

James Wadleigh, chief information officer of Connecticut's exchange, said he was looking at having a new vendor support identity verification in addition to the federal vendor. He also said he wanted to be able to tap state databases, such as the labor department's, to validate incomes and was seeking a way to prove people were legal residents without depending on U.S. data.

Mr. Wadleigh said he wants Connecticut to be self-reliant and serve its residents even when the federal government has to take down parts of its technology for maintenance. Some other states are watching his effort.

A spokesman for the Centers for Medicare and Medicaid Services, the agency implementing the health law, said the federal data hub continued to work well and has done so consistently since Oct. 1.

Insurers also are telling the administration they want more help to work around the federal system so they can enroll many customers directly.

The U.S. has begun a pilot program with insurers in three big states—Florida, Ohio and Texas—to identify problems in the current system, in which insurance companies still have to send would-be customers briefly to the site to verify their eligibility for financial assistance, where many have become stuck. The government describes the direct-signup effort as a way to give consumers more choice in gaining coverage.

The Centers for Medicare and Medicaid Services also is trying to develop a formula that could be used by the administration's call centers and other enrollment workers to calculate the value of tax credits for some people with straightforward circumstances, to relieve pressure on the website, said people familiar with the effort.

On Sunday, as a Nov. 30 deadline set by the administration for improvements to the site had passed, CMS issued a report concluding: "We believe we have met the goal of having a system that will work smoothly for the vast majority of users."

View Full Story From The Wall Street Journal