Sebelius: You’re Not Covered under Obamacare Until You Pay

By Melanie Arter | December 11, 2013 | 11:48am EST

Health and Human Services Secretary Kathleen Sebelius (AP Photo/J. Scott Applewhite)

( – Health and Human Services Secretary Kathleen Sebelius testified Wednesday before the House Energy and Commerce Committee that those who signed up for Obamacare are not actually covered until they pay the insurance company.

“You have to be enrolled by the 23rd and make a payment by the end of the year in order to be fully insured,” Sebelius told Rep. Michael Burgess (R-Texas).

So far, 364,682 people have signed up for Obamacare as of Nov. 30, according to enrollment statistics from HHS, which is less than one-third of the 1.2 million enrollees that the administration predicted would sign up by the end of November. That number may change significantly once final enrollment statistics are compiled of those who have actually paid for their health insurance.

Burgess said he was unable to make a payment for health insurance on the federal exchange website for Texas.

“I was unable to make my payment on on the federal exchange for the state of Texas, and I was told you can’t make that payment,” he said.

“You make it through an insurance company – you don’t pay the federal government. We are the sign-up site, and you make the payment directly to the insurer,” Sebelius said.

“December 23, you said if someone has worked through the process, they’re gonna be covered, but payment may not have been made. Is that correct?” Burgess asked.

Sebelius explained that the enrollment deadline is Dec. 23, but the payment must be made by the end of the year to be fully insured.

“Who is going to guarantee that the doctor that sees that patient on January 4th is actually covered for that visit?” Burgess asked.

“The insurance company as they do today. You are enrolling in a private insurance plan. You have to pay your premium in order to be covered,” Sebelius said.

Burgess: What if that patient doesn’t make the premium payment? You said they’re covered Dec. 23, but they never write the check. They never make the payment.

Sebelius: Then they’re not covered. They are not enrolled, and at every point along the way, on the website they are told until they make the payment—

Burgess: Are you going to make good for those doctors who see those patients the first couple of weeks of January who then have their cash flow interrupted? I’ll just tell you for practicing in a small practice, you get your cash flow interrupted for two or three, four weeks, that’s big trouble.

Sebelius: Well again if an insurance company gives an enrollment to a customer, they will make good with the provider. We tell people over and over again they are enrolled when they make a payment. We turn their name over to the insurance company, and the insurance company deals with their new customer.

Burgess: If they’re enrolled by the 23rd, they’re gonna be covered.

Sebelius: Sir, not until they pay, and that’s what every step along the site says.

Burgess: Do you know how hard it is to actually make that payment, hold your billfold out and actually make that payment? Have you done that yourself?

Sebelius: I have not.

Burgess: Well I’ll tell you, it’s almost impossible. I’ve never seen a business where you get to the point in the fundamental business transaction where you’re gonna make the payment, and you can’t do it. That is a flawed system.

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