Obamacare Day 1: Exchanges Struggled With High Demand; Fixes Promised

By | October 1, 2013

The Obamacare insurance exchanges struggled to handle a flood of consumer interest that closed the U.S. website for much of the day, and caused start up delays for most of the marketplaces run by the states.

In New York, officials said the exchange had 2.5 million visitors in the first half hour and California reported seeing as many as 10,000 hits a second. While Republicans pounced on the breakdowns as evidence the law doesn’t work, President Barack Obama said the volume “gives you a sense of how important this is to millions of Americans.”

The problems created a rocky debut for the system at the center of the Affordable Care Act’s efforts to cover more of the 48 million uninsured Americans. The exchanges are supposed to help consumers access federal subsidies and choose from a menu of private insurance plans that take effect Jan. 1, when the law requires all Americans to obtain insurance.

“Like every new law, every new product roll-out, there are going to be some glitches in the sign-up process along the way that we will fix,” Obama said today at a White House event.

While the federal site was down for much of the day, administrators “added capacity and made adjustments” to put it back into service by late afternoon, said Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, on a call with reporters. Tavenner declined to say how many people were enrolled in health plans through the exchanges.

Government Shutdown

The marketplaces opened as the U.S. faced its first partial government shutdown in 17 years. The shutdown didn’t delay the exchanges because they’re funded largely through mandatory spending not affected by a budget showdown borne of Republican opposition to the law. Enrollees don’t have to complete the process until Dec. 15 to guarantee coverage on Jan. 1.

The president is “the same guy who promised his health- care ideas would make Americans’ premiums lower, and that they’d be able to keep the plans they liked,” said U.S. Senator Mitch McConnell of Kentucky, leader of the chamber’s Republicans, in an e-mail. “So forgive me for a being a little skeptical, given how these other rosy scenarios have played out.”

While delays persisted, frozen and sluggish websites improved through the day. Of the 14 states and Washington D.C. that have built their own exchanges, all but five allowed users to register by midafternoon New York time, albeit with waits in states including California and Maryland. Hawaii and New York’s sites remained down at 5 p.m.

7 Million Targeted

The administration is seeking to get about 7 million people to buy policies through the exchanges in the open enrollment period that runs through March. The federal site had 2.8 million visitors since midnight and 81,000 more people used an exchange call-in line, Medicare’s Tavenner said.

Insurer shares climbed amid signs of high interest. Health Net Inc., the Woodland Hills, California-based carrier with a heavy presence on its home-state exchange, rose 3.6 percent to $32.84 at the close of New York trading. Indianapolis-based WellPoint Inc., the biggest seller of coverage to individual Americans, gained 3 percent to $86.11.

In California, the state with the most uninsured Americans, “we are having huge volume,” said Peter Lee, the exchange’s executive director. He said the site was getting as many as 10,000 hits a second.

“We are live,” Lee said. “Our state workers are answering the phone.”

In New York, the website was still experiencing delays at 5 p.m. after the initial surge and officials were urging consumers try the call-in line instead.

Slow ‘Wheels’

“The not-so-good news is the wheels aren’t turning as quickly as they could,” said Cesar Perales, New York’s secretary of state, at a news conference in New York City. “We are doing something that has never been done before.”

In Florida, the state Blue Cross plan found customer calls were higher than expected, and the debate over the government shutdown may actually have raised awareness, said Patrick Geraghty, the plan’s chief executive officer.

“Different things can stoke the public’s attention and that probably helped make people aware this was happening,” Geraghty said in an interview.

It remained unclear, though, how the wave of interest would translate into actual enrollments. In Connecticut, 167 people applied for coverage as of 4 p.m., said Kathleen Tallarita, a spokeswoman with Access Health CT, the state’s exchange. The exchange’s website had 28,280 unique web hits and the state’s call center took 1,930 phone calls, she said.

Both the uninsured and those trained to help them enroll expressed frustration over the delays.

‘Bad Taste’

Teajai Kimsey, 49, of Wichita, Kansas, runs the website Internet Idea Girl and is uninsured. When she logged on to healthcare.gov this morning, it took her about five minutes to get into the system, she said. Then the security question didn’t work and a drop-down bar failed.

“If you don’t know the web well, it will be really discouraging and leave a bad taste in your mouth,” Kimsey said in a telephone interview. “They have some first-day bumps. I’m more tolerant, I know this happens.”

In Maryland, Rebecca Wener and Apoorva Srivastava had a week of training to become exchange navigators in preparation for today’s start. They expected to have a busy morning signing people up for insurance at Community Clinic Inc., a Silver Spring health center that serves the uninsured.

Instead, they handed out fliers about the program and tried to set up appointments for patients to come back later and sign up online.

‘1972 Honda’

“It’s a glitch,” said Srivastava, who expected to take patients to a computer, where they could learn what subsidies they’d be eligible for, and where they could sign up. “In training, they described the roll-out as a 1972 Honda. It will get there, but it won’t have all the luxuries.”

Jason Kaufman had more luck. An independent contractor with an Illinois marketing company, he’d been unable to get insurance since being diagnosed with a gastric virus four years ago. He signed up today in Chicago, he said.

“There will be glitches,” Kaufman, 32, said in an telephone interview. The law, though, “gives people like me a chance not to have to care about what happened in the past and to move on to a fresh start.”

People eligible for coverage can go to healthcare.gov to find their state’s insurance exchange. Monthly prices for the lowest-tier of plans average $249 nationwide. People with incomes less than about four times the poverty level will get discounts on their premiums by way of tax credits. For a family of four, that means those with incomes of less than about $94,000 qualify for the credits.

Expanded Medicaid

People with incomes under about 1.4 times the poverty level may be able to enroll in expanded Medicaid programs for the poor in about half the states.

The Obama administration had warned of early problems for weeks and even states that have cooperated with the law’s rollout had downplayed today’s debut, saying they wanted to avoid having their websites and call centers overwhelmed.

Maryland pushed back the planned 8 a.m. opening of its online marketplace until noon, according to a message on its website that said the exchange was “experiencing connectivity issues.”

In Minnesota, which built its own exchange, residents were able to check prices and determine if they qualify for subsidies on the new MNsure website. Those who need help won’t be able to get assistance from navigators and other groups until tomorrow at the earliest, April Todd-Malmlov, MNsure’s excutive director, said. The 5,000 individuals preparing for those positions still need to complete training and clear background checks, she said.

Enrollment Options

“Consumers will have plenty of time to evaluate their options,” Todd-Malmlov said. “We are anticipating there will be a lot of interest in the site, but we don’t anticipate there will be a lot of applications in the first few weeks.”

Republicans, who control the U.S. House, had demanded a delay or dismantling of the health law as part of the funding bill. Democrats, who make up the majority of the Senate, refused to concede.

The $1.4 trillion Affordable Care Act requires most Americans to obtain health insurance starting next year or pay a fine. To make finding coverage easier, the law set up government-run exchanges in each state where most consumers can buy plans from insurance companies with the help of tax credits.

About two-thirds of uninsured people said they plan to buy medical coverage next year rather than pay a fine, according to a Gallup poll published yesterday.

–With assistance from Meg Tirrell, Shannon Pettypiece and Elizabeth Lopatto in New York, Michelle Fay Cortez in Minneapolis, Stephanie Armour, Alex Wayne and Anna Edney in Washington, Alison Vekshin in San Francisco, Mark Niquette in Columbus and Annie Linskey in Boston. Editors: Reg Gale, Andrew Pollack

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