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While the Administration has given itself passing grades on its self-imposed December 1 deadline, the real problems lie under the surface, in what is known as the back-end. In short, just because someone thinks they have signed up, doesn’t mean the correct information has been sent to the insurance company.

A detailed report in the Times explores what will be a huge problem come 2014: People who thought they signed up, were not properly signed up. And they probably won’t realize it till they go to the doctor’s office, and are denied coverage.

Insurers said they had received calls from consumers requesting insurance cards because they thought they had enrolled in a health plan through the federal website, but the insurers said they had not been notified.

“Somehow people are getting lost in the process,” the insurance executive said. “If they go to a doctor or a hospital and we have no record of them, that will be very upsetting to consumers.”

Think about that. People manage to sign up, but because garbled data is sent to insurance companies, their policy may never be registered. How would the mandate penalty/tax work in such cases?Or, they may sign up for one plan, but they are actually signed up for another plan. That’s the type of problem you don’t find out until there is a dispute.

As it stands now, the information being sent to the insurance companies is not complete. And this is bad news for the few people who have managed to actually sign up.

The problem is that so-called back end systems, which are supposed to deliver consumer information to insurers, still have not been fixed. And with coverage for many people scheduled to begin in just 30 days, insurers are worried the repairs may not be completed in time.

“Until the enrollment process is working from end to end, many consumers will not be able to enroll in coverage,” said Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group.

The issues are vexing and complex. Some insurers say they have been deluged with phone calls from people who believe they have signed up for a particular health plan, only to find that the company has no record of the enrollment. Others say information they received about new enrollees was inaccurate or incomplete, so they had to track down additional data — a laborious task that would not be feasible if data is missing for tens of thousands of consumers.

In still other cases, insurers said, they have not been told how much of a customer’s premium will be subsidized by the government, so they do not know how much to charge the policyholder.

…

But neither Mr. Zients nor the Department of Health and Human Services indicated how many people were completing all the steps required to enroll in a health plan through the federal site, which serves residents of 36 states.

And unless enrollments are completed correctly, coverage may be in doubt.

For insurers the process is maddeningly inconsistent. Some people clearly are being enrolled. But insurers say they are still getting duplicate files and, more worrisome, sometimes not receiving information on every enrollment taking place.

“Health plans can’t process enrollments they don’t receive,” said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans.

How bad is it?

Thomas W. Rubino, a spokesman for Horizon Blue Cross Blue Shield of New Jersey, which says it has about 70 percent of the individual insurance market in the state, said the company had received “some but not a lot” of enrollments from the federal exchange.

Federal officials are encouraging insurers to let consumers sign up directly with them. But in the middle of this online enrollment process, consumers must be transferred to the federal website if they want to obtain tax credit subsidies to pay some or all of their premiums in 2014.

In a document describing problems with the federal website in late November, the administration said some consumers were “incorrectly determined to be ineligible for” tax credits. In some cases, it said, enrollment notices sent to insurers were missing the amount of the premium to be paid by a consumer, the amount of subsidies to be paid by the government and even the identification number for a subscriber.

In some cases, according to the document, government computers blocked the enrollment of people found eligible for subsidies that would pay the entire amount of their premiums. In other cases, the government system failed to retrieve information on a consumer’s eligibility for financial assistance.

Plus, the mechanisms to actually pay the insurance companies is not even complete.

Insurers said they were alarmed when Henry Chao, the chief digital architect for the federal website, estimated that 30 to 40 percent of the federal insurance marketplace was still being built. He told Congress on Nov. 19 that the government was still developing “the back office systems, the accounting systems, the payment systems” needed to pay insurers in January.

While insurers will start covering people who pay their share of the premium, many insurers worry the government will be late on the payments they were expecting in mid-January for the first people covered.

“We want to be paid,” said one executive, speaking frankly on the condition of anonymity. “If we want to pay claims, we need to get paid.”

And this line is brutal:

Whether Mr. Obama can fix his job approval ratings as well as the website is unclear. Public opinion polls suggest he may have done more political damage to himself in the last two months than Republican attacks on the health care law did in three years.

 

Lawrence Hurley has the early report:

The U.S. Supreme Court on Monday declined to hear a broad new legal challenge to President Barack Obama’s 2010 healthcare law.

The court rejected a petition filed by Liberty University, a Christian college in Virginia, which had raised various objections to the law, including to the key provision that requires individuals to obtain health insurance.

You may recall that after NFIB v. Sebelius, the Court remanded Liberty University for further consideration. It seems that the Court was content with the Fourth Circuit’s opinion dismissing the challenge. Jon Adler blogged about the 4th Circuit’s opinion here. I noted earlier that Judge Motz, who was on the Liberty University panel, had indicated that NFIB “puts a new light on the Commerce Clause.”

Harvard may have beat Yale in The Game, but in this letter to the editor of the New York Times, point goes to New Haven.

Who Wrote the Bluebook?

To the Editor:

“The Bluebook” is the iconic citation manual that dominates legal writing. Kenji Yoshino reviews Richard A. Posner’s book “Reflections on Judging” (Nov. 10), which notes that the Bluebook was created by the future judge Henry Friendly or the future Harvard dean Erwin Griswold when they were students at Harvard Law School in 1926.

The Yale Law Library, however, has in its rare-book collection a pamphlet titled “Abbreviations and Form of Citation,” issued by The Yale Law Journal in 1921; our copy appears to be the only one in existence. A comparison of the 1921 Yale pamphlet with the 1926 first edition of the Bluebook shows that the Bluebook took most of its content, often word for word, from Yale’s product. Some may say that originating the ­hypercomplicated Bluebook should not be a source of pride, but The Yale Law Journal ur-Bluebook consisted of only 15 tiny pages. The version that has developed under the leadership of the Harvard Law Review currently consists of over 500 large pages, and users may need software such as the pioneering CorrectCite to help them navigate its mysteries.

FRED SHAPIRO
NEW HAVEN

The writer is an associate librarian and a lecturer in legal research at Yale Law School.

H/T Law School Reports

Today the Supreme Court denied cert in Judd v. Libertarian Party of Virginia. It presented this question:

Whether the court of appeals correctly held that a Virginia statute requiring that signatures on third-party presidential ballot petitions be witnessed by Virginia residents violates the First Amendment, where the Commonwealth failed to produce evidence that such a requirement served its compelling interests, or that less restrictive means would be ineffective.

In the obituary for the late Henry Lind, the reporter of the Supreme Court, was this interesting nugget:

In 1986, with an increase in the number of cases involving pot, Mr. Lind pushed the justices to decide how to spell the word “marijuana” — with an “h” or “j.” Although Mr. Lind reportedly suggested that the court “just use cannabis,” the justices voted to change the Court’s style to the more modern “j” spelling.

Mr. Lind reported the result: Four justices favored the “j” spelling, one voted for the “h” spelling, three cast him as their proxy and one justice abstained.

So which Justices voted which way? 1986 is a tricky year, because depending when the question was asked, we would have either CJ Burger or a young Justice Scalia.

I did a search for “marihuana” between 1985 and 1987. I found none later than February 1986, which suggests the change was made before the start of OT 1986, so Nino would not have been on board.

In 1985 and 1986, who spelled it marihuana? There were a total of five opinions.

I found three by O’Connor, one by Stevens, one by CJ Burger. My guess is that it was Justice O’Connor who insisted on spelling it marihuana.

File this in the department of irrelevance.

Update: Apparently this is not so relevant. Tony Mauro wrote about this issue in 1986, and also wrote a letter to the Greenbag in 2008 (when I think I was a student of Ross Davies) documenting a letter the Reporter of Decisions sent to Justice Marshall about the spelling of marijuana/marijuana, and subsequent polling of all the Justices.

Unbeknownst to me, but confirmed by documents in the Thur- good Marshall papers at the Library of Congress (Box 378, Folder 2) the article got noticed inside the Marble Palace. Reporter of Deci- sions Henry Lind sent a copy to the justices, along with a memo de- tailing the spelling preferences of several dictionaries. He asked the justices to vote on how to spell the cannabis-bearing plant. A few days later, Lind reported the results: four justices favored “j,” one favored “h,” and three gave Lind their proxies, which he cast in fa- vor of “j.” Lind declared the issue resolved: “[T]he spelling from now on should be a ‘j.’ I hope that this will settle the matter.”

In the letter, Lind writes:

A majority vote will control (I hope there won’t be a “splintered” vote).

And it splintered:

There were four votes for “marijuana,” one vote for “marihuana,” and three Justices gave me their proxies, which I have case for “marijuana.”

Well done Tony!

H/T Michelle Olsen (the quickest twitterer around)