The health exchanges, the centerpiece of the Affordable Care Act that allows Americans to sign up for health insurance online, have been plagued with embarrassing glitches, error messages, and loading delays. Despite all the problems, more than 476,000 users have filed applications for health insurance, the Obama administration announced on Saturday.
“It strikes me as a very positive number, especially given how hard it was to get through the process on healthcare.gov and in some states. Presumably it would have been far higher if not for glitches and hiccups,” Larry Levitt, senior vice president of the Kaiser Family Foundation, told ">Politico.
Shortly after going live on Oct. 1, the federal and state health insurance exchanges were inundated with visitors seeking new health plans. Americans can also use the site to determine whether they are eligible for federal subsidies for private insurance or newly eligible for Medicaid. As of Friday night, 19 million have visited Healthcare.gov, the access point to the 14 state-run exchanges and the federal exchange supporting the other 36 states which opted out of running their own.
Practically all of the federal and state-run exchanges immediately faced problems, which some attribute to the high demand for health insurance. Users hit brick walls in the application process, which requires the collection of income information that needs to be verified by other federal agencies. On the backend, insurers who will ultimately enroll people into their health plans say they face problems receiving applicant information that is complete and accurate.
After some disastrous starts, many of the state exchanges are finally operating smoothly, including Kentucky, Washington, and California. “I’m very proud of my state of California, where it’s going great,” said Minority Leader Nancy Pelosi. “And most of the states that have their state-run exchanges, it’s all going positively well."
Frustration With Glitches And Efforts To Fix Them
President Obama told his team that there are no excuses for not having the website ready to operate, according to the Associated Press. White House Press Secretary Jay Carney described the president as "not happy." The embarrassing start of the health insurance exchanges, the most public piece of health reform, has been derided by Republican opponents of the law as evidence the ACA is flawed.
"The website is unacceptable, and we are improving it, but the product is good and across the country people are getting access to affordable care starting January 1," one administration official said. "We are going to work intensely for the next six months to make sure we meet the demand."
The White House has yet to issue a full explanation, but President Obama is expected to address the issue during a healthcare-themed event scheduled for Monday. The administration has undertaken efforts to remedy the problems, including hiring more programmers and experts. Staff at call centers increased by 50 percent to handle calls regarding technical difficulties, and the administration is encouraging people to sign up through the phone.
An internal memo acquired by the Associated Press revealed that the administration predicted 500,000 people would apply for a health plan through the exchanges in the first month. Yet, the number of applicants does not tell the whole picture because it doesn’t show how many people successfully enrolled in a health plan. Applying through the site is only the first step. Once the application is verified, visitors can use the site to shop for plans and finally enroll.
The Affordable Care Act And The Health Exchanges: Looking Ahead
There is still time for Americans to enroll and for the administration to fix the problems. For coverage starting Jan. 1, people must enroll by Dec. 15. Open enrollment for 2014 continues until March. The Congressional Budget Office predicts that 7 million uninsured people will enroll in private insurance through the marketplaces, in addition to millions more signing up for Medicaid.
Officials also predicted that more people would enroll later as deadlines near, and not just because of technical delays. The individual mandate — the requirement that most people buy health insurance or face a penalty — kicks in Jan. 1, 2014, though people will not be fined until Mar. 31. Once people become more aware of the mandate, more are likely to turn to the site.
Ironically, the exchanges' flaws received less media attention in the shadow of the government shutdown intended to overturn the law, although it is likely to face more scrutiny in the upcoming weeks. An oversight panel is scheduled for Oct. 24 to address the flaws in the exchanges. Department of Health Human Services Secretary Kathleen Sebelius declined an invitation to attend, drawing criticism from some Republicans.
“It’s important to remember the website alone is not the Affordable Care Act,” White House Press Secretary Jay Carney said.