How An Obscure Government Code — 834 — Became Big In 2013
Oregon is still using paper applications to enroll people in coverage under the Affordable Care Act.
Monday is the last day Americans in most states will be able to enroll in Affordable Care Act health exchanges if they want coverage to start in January. But technical problems have foiled sign-ups from the start, which led an otherwise obscure number to become a big deal in 2013.
The government code for electronic files â 834 â came up a lot in the news this fall. What is it? The 834 forms are read by computers, not humans. They give insurance companies basic information about customers â name, contact information, social security number â so the health plans can enroll consumers. It's critical they get to insurers accurately so insurance plans can bill for premium payments and start coverage.
"It's remarkable that this obscure decades-old data file format has actually been so much in the news this fall," says Larry Levitt, a health industry watcher with Kaiser Family Foundation. He says 834's would never have gotten this kind of attention had HealthCare.gov actually worked smoothly at launch.
"There was a bit of [a] hidden problem with these 834 files [in October and November], so even when people could get through the system and actually apply for coverage and pick a plan, it turns out that much of the information was never making it to the insurance company," Levitt says. "In the first couple of months as many as 15,000 people simply didn't even exist in the 834 files. That problem seems to have gone away."
The 834 files may be sending clean information now, but for the previously missing or inaccurate files, reconciling the data entered into HealthCare.gov with information insurance plans received started early this month.
"We are in the process of actually hand-matching individuals with insurance companies," Health and Human Services Secretary Kathleen Sebelius said on Capitol Hill in early December.
The rush to finish matching files and process the enrollments still coming in had some people panicked about gaps in coverage. That's because an administration rule said consumers were required to send in their first month's premium payment by the end of December for coverage to start in January. But given the thorny back-end problems with the 834's, health insurance plans have extended the payment window to Jan. 10.
"They wanted to make sure consumers could have peace of mind, that they could enjoy their holiday break with their families and not worry that their payment did not make it there by Dec. 31," says Robert Zirkelbach, who represents the insurance industry group America's Health Insurance Plans.
President Obama says he expects the mismatched files and missing information will be fixed in time for people to get their coverage in January.
"Then I think all eyes will turn to January," says Levitt. "To make sure people who think they have coverage actually are insured and can go to the doctor, go to the pharmacy, and get services."
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Transcript
ARUN RATH, HOST:
It's ALL THINGS CONSIDERED from NPR West. I'm Arun Rath.
A key deadline is coming up on Monday. December 23rd is the last day most states will let you sign up for health coverage if you want it to start in January. Technical problems have foiled these sign-ups from the start. So as part of our Numbers of the Year series, NPR's Elise Hu explains Obamacare's most important figure: 834.
ELISE HU, BYLINE: 834 is government-speak for electronic files read by computers, not humans. They give insurance companies customer sign-up information so health plans can enroll people. It's critical they come in accurately, so insurers can actually start coverage.
LARRY LEVITT: It's remarkable that this obscure decades-old data file format has actually been so much in the news this fall.
HU: Larry Levitt is a health industry watcher with Kaiser Family Foundation. He says 834s would never have gotten this kind of attention had the HealthCare.gov system actually worked at launch.
LEVITT: There was a bit of a hidden problem with these 834 files. So even when people could get through the system and actually apply for coverage and pick a plan, it turns out that in many cases, that information was never making it to the insurance company. I mean, in the first couple of months, as many as 15,000 people simply didn't even exist in the 834 files, that problem seems to have gone away.
HU: 834s are sending clean information now. And data reconciliation for previously missing or inaccurate files started early this month, as Health and Human Services Secretary Kathleen Sebelius said on Capitol Hill.
SECRETARY KATHLEEN SEBELIUS: We are in the process of actually hand-matching individuals with insurance companies.
HU: The rush to finish matching files and process enrollments still coming in had some people panicked about time gaps in coverage. An administration rule had said consumers were required to send in their first month's premium payment by the end of December for coverage to start in January. But given the thorny back-end problems with the 834s, health insurance plans have extended the payment window to January 10th. Robert Zirkelbach represents industry group America's Health Insurance Plans.
ROBERT ZIRKELBACH: They wanted to make sure consumers could have peace of mind, that they could enjoy their holiday break with their families and not worry that their payment didn't make it there by December 31st.
HU: On Friday, the president took blame for how the bad rollout forced these late adjustments.
PRESIDENT BARACK OBAMA: Since I'm in charge, obviously, we screwed it up.
HU: But he's still confident about the end result.
OBAMA: We've got a couple million people who are going to have health insurance just in the first three months despite the fact that probably the first month and a half was lost because of problems with the website.
HU: The test ahead is whether those millions will be found on the insurance rolls. Kaiser's Larry Levitt.
LEVITT: All eyes will turn to January to make sure that people who think they have coverage actually are insured and can go to the doctor, go to the pharmacy and get services.
HU: 2013 may be going away, but 834s will have to work well into the new year. Elise Hu, NPR News, Washington. Transcript provided by NPR, Copyright NPR.
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