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Insurers under fire as Obamacare kicks in

New policyholders are having trouble confirming coverage, obtaining ID numbers and getting care.

January 10, 2014|By Chad Terhune
  • WellPoint, the nation’s second-largest health insurer and parent of Anthem Blue Cross, said it received more than 1 million customer calls over two days last week, equal to the amount it typically receives over an entire month. Above, company headquarters in Indianapolis.
WellPoint, the nation’s second-largest health insurer and parent… (Darron Cummings, Associated…)

Obamacare's biggest problem isn't the troubled website anymore.

Consumers are easing up on criticism of government exchanges and turning their frustration and fury toward some of the nation's biggest health insurers. All too often, new policyholders say, the companies can't confirm coverage, won't answer basic questions, and haven't issued identification numbers needed to fill prescriptions or get medical care.

Day after day, people say, they contact insurance company call centers waiting hours at a time with no response. Meantime, insurers have already taken many customers' payments for coverage intended to take effect Jan. 1.

But without proof of insurance, patients are having to pay hundreds of dollars out of pocket for medications and doctor visits, if they can afford it. Insurance agents say dismal service has become commonplace across many companies.

These industry problems pose the next major hurdle for what's already been a flawed rollout for President Obama's signature law. It could further sour public opinion on the overhaul and hamper enrollment efforts through March 31, when the first sign-up period ends.

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Alan Sager, a health-policy professor at Boston University, said the insurance company fiascoes are another barrier to overcome after the government website problems.

"There's equal opportunity for incompetence by the public and private sector in administering such a large new program," he said. "People are deservedly angry and resentful."

Some insurers have begun to apologize this week, acknowledging a lackluster response amid an unprecedented surge of applicants for the individual insurance market. Nationwide, more than 2 million people enrolled in private health plans by the end of last year, either through or state-run marketplaces.

Industry officials say the disastrous launch of the federal exchange and the ever-changing rules from the Obama administration have complicated their job and contributed to the backlog.

"Health plans have gone above and beyond to protect consumers from disruptions caused by the ongoing problems with" and some state exchanges, said Robert Zirkelbach, spokesman for America's Health Insurance Plans, an industry group. "The last-minute changes to deadlines and rules have made the process more complicated and time-consuming."

But some consumers think big insurers had plenty of opportunity to get ready.

"Insurance companies of this size should have been far better prepared. They knew it was coming," said Katherine Kokko, 34, a public-health consultant in New Hampshire.

She easily signed up for an Anthem Blue Cross Blue Shield policy through on Dec. 20 and soon after paid her $325 monthly premium. But after waiting on hold more than 10 hours in all this week, a company representative said she didn't have an identification number. As a result, Anthem wouldn't authorize physical therapy she needs after knee surgery last month.

These problems are particularly acute for families with ongoing medical needs, such as cancer treatment, pregnancy and other chronic conditions.

Bill Strong of Santa Barbara has a 6-year-old daughter who requires 24-hour care for a rare disease, spinal muscular atrophy. The family's previous plan was canceled because it didn't meet all the requirements of the Affordable Care Act. The family enrolled with Blue Shield of California on Dec. 23 and paid its $1,000 monthly premium for a Platinum plan.

But Strong said he hasn't heard anything from the company despite two weeks of phone calls. Strong already paid for one prescription himself, and his daughter is scheduled to get a $4,000 injection Friday. Also, his wife is nine months pregnant.

"The company is not set up to handle the volume coming through," Strong said. "It's creating a lot of stress on us we don't need."

Blue Shield of California apologized to customers for its "unacceptable" performance on its Facebook page this week.

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"While we anticipated and planned for increased traffic, the sheer volume of enrollments has swamped all major health plans," the San Francisco insurer said.

WellPoint, the nation's second-largest health insurer and parent of Anthem Blue Cross, has drawn the ire of many customers in California and 13 other states where it's selling policies on and off government exchanges.

The company said it responded to more than 1 million customer calls over two days last week, equal to the amount it typically receives over an entire month. It said it has more than 1,000 employees answering calls.

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