Health-insurance-enrollment counselors in several large states said on Monday that the problem-plagued HealthCare.gov was operating reasonably well for the first time since its Oct. 1 launch, with clients able to use the site with relative ease throughout the day. Despite marked improvement in the website’s consumer functions, it is unclear what back-end problems remain and if the millions of Americans expected to purchase plans through the new insurance marketplace will be able to do so in time to have coverage that begins on Jan. 1.
“There’s definitely been a huge improvement in the stability of the system and in the error messages,” says Melisa Garcia, vice president of clinical business services for Legacy Community Health Services in Houston, which employs some 30 certified application counselors that assist those signing up for coverage. “It’s been exponentially different,” says Jodi Ray, project director for Florida Covering Kids and Families, which received a $4 million Affordable Care Act (ACA) grant to facilitate enrollment.
But even with the improvements, only a small percentage of people these counselors have helped to access the site have actually purchased coverage. Of the approximately 2,000 consumers Legacy has helped to use the insurance marketplace, Garcia says she can confirm that just 32 had signed up for coverage. (The rest may still be reviewing plans or planning to finish the process on their own.)
Those low numbers track with the total figures for October, when the Department of Health and Human Services (HHS) said just 106,185 people enrolled in new health insurance through HealthCare.gov and state-run ACA insurance websites. That total included consumers who had selected plans but not yet paid for them, and HHS had reportedly predicted some 500,000 would sign up during the month. HHS has said it will release enrollment figures for November later this month.
“October was homework month. November was window-shopping month. December is ‘Let’s hope they buy it’ month,” says Lisa Hamler-Fugitt, executive director of the Ohio Association of Foodbanks, which received a $2 million ACA grant to help consumers enroll in coverage.
Enrollment counselors say many consumers shopping in the federal insurance exchange and those being run by 14 states are unfamiliar with the complexities of selecting health insurance. These consumers must compare premiums, deductibles, co-pays, co-insurance and the types of drugs covered by various plans — a time-consuming process that could not begin when the federal website wasn’t working properly. And time is of the essence: for plans beginning on Jan. 1, the first month’s premium needs to be paid by Dec. 23.
“Everybody doesn’t talk insurance,” says Ray. “All they know is ‘I need to see a doctor, and I haven’t had a mammogram in seven years because I haven’t had health insurance.’”
Signing up for coverage through HealthCare.gov is often a multiday process for consumers buying plans on their own. For those in need of assistance at one of thousands of community organizations facilitating enrollment across the country, that can mean making multiple trips to meet with in-person counselors.
“Unless clients come in completely prepared and having done a lot of research ahead of time, we don’t recommend they purchase until they get a chance to go through all the plans,” says Garcia. Multiple appointments with enrollment counselors and “navigators,” consumer-assistance workers whose salaries are paid through the ACA, has strained community-based nonprofit organizations like Legacy. “Some people need multiple appointments just to get to the point where they could compare plans,” says Garcia. “We have people working later in the evenings, weekends. It has been a drain on resources.”
Federal health officials said traffic to the improved website surged on Monday, with 750,000 visitors as of 5:30 p.m. A new queuing system was employed whenever about 35,000 users logged on, according to Centers for Medicare and Medicaid Services spokeswoman Julie Bataille, meaning many consumers had to wait for available website slots to sign up for accounts and select plans. Bataille said one software bug that has caused insurers to receive garbled consumer information has been repaired, but she declined to release data on how frequently insurers had received incorrect information or how widespread the problem remains. She recommended that consumers contact insurers directly to verify their enrollment. Insurers have said back-end website problems could cause some consumers to incorrectly believe they have coverage when they do not. And some reporters and consumers using HealthCare.gov on Monday said they had encountered error pages, despite Bataille’s assurances that the website was working well.