Monday, February 3, 2014 Appeals System Not Working

Truth makes many appeals, not the least of which is its power to shock.

Jules Renard (1864-1910), French writer

It may shock you,  but you cannot appeal if makes an error when you seek to enroll in the government’s health exchange program.

The  Washington Post  and Reuters report that 22,000 Americans have filed appeals to the government that charged them too much for health insurance,  steered them to the wrong insurance payer, or denied them coverage entirely.

Those appealing got no reply. The computer was mute. It will come as a shock, but  the federal computer appeals system has yet to be built. Appeals are sitting, untouched, somewhere deep in the bowels of a government computer. Appealing to federal workers does not help.  Workers cannot go into enrollment records to retrieve or change them.

The Obama administration has yet to fess up to this gap  in the system, even though ObamaCare guarantees due-process rights to Americans who have been denied coverage or who are  victims of federal errors.  Aaron Albright, CMS spokesperson, says not to worry,  “We are working to fully implement the appeals system.”  But when? It is unclear when it will be fixed.     

The appeals component is just one of many parts of the system that do not work- a payment system for insurers, exchange information with state Medicaid , adjusting coverage to accommodate new babies and other major changes in life circumstances,  failures to properly compute subsidy levels.

Phone calls and emails do not do when it comes to correcting errors.  You must fill out a 7 page form and mail it to Kentucky, where it is scanned and set to a CMS computer, where it may or may not be processed.  CMS, meanwhile is advising consumers to appeal to start all over again, because the system is working better now.

In closing, allow me to paraphrase  lyrics of a  Pete Seeger song, “Where Have All the Flowers Gone?”

Where have all the appeals gone, long time passing
Where have the appeals gone, long time ago
Where have the appeals gone,
Gone to the computer graveyard, every one
Oh, when will they ever learn
Oh, when will they ever learn

Tweet:  Americans appealing  errors committed by are frustrated because the appeals system has yet to be built.


1.       Amy Goldstein, “ Can’t Handle Appeals of Enrollment Errors,” Washington Post, February 2, 2014
2.      “Online Care Computers Not Yet Equipped to Handle Errors,” Reuters,  February 2, 2014

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