Arizonans finding work-arounds in bid to sign up for health coverageby Ken Alltucker on Oct. 23, 2013, under Arizona Republic News
The website that serves as the backbone of the nation’s health-care overhaul is supposed to extend health insurance to the uninsured masses with just a handful of keystrokes.
But the website has become a point of frustration for millions of American consumers who have run into delays, blank screens and error messages during repeated unsuccessful attempts to browse and buy health insurance plans.
What started as a minor annoyance has developed into political crisis for President Barack Obama’s administration, with questions about when the president was aware of technical malfunctions that were known days and weeks before healthcare.gov launched on Oct. 1.
Some have even called for the firing of Health and Human Services Secretary Kathleen Sebelius, who visits Phoenix today. She’ll meet stakeholders, tour a call center and answer questions about the new online health-insurance marketplace, which is expected to extend coverage to 7 million uninsured Americans by the end of March under the Affordable Care Act. From Phoenix, Sebelius will promote the health-care law at stops in Austin and San Antonio.
But as the Obama administration seeks to ease the public’s concerns over the marketplace’s functionality, Arizona consumers, brokers and insurance companies have resorted to extraordinary steps to get people covered.
The law requires most Americans to get health insurance in 2014 or pay a penalty, which equals the greater of $95 or 1 percent of income. The penalty jumps to $695 or 2.5 percent of income in 2016. Many are exempt from the mandate, including some religious objectors, Native Americans and those who don’t earn enough to file a federal tax return.
Individuals who earn up to $45,960 may be eligible for sliding-scale tax credits to help offset the cost of insurance, and low-income residents who earn up to $15,282 may be eligible for Medicaid, the government-sponsored insurance program for low-income earners.
Some have resorted to filling out and mailing paper applications to the federal agency that oversees enrollment to complete what the website has largely failed to do. Other insurers have compiled waiting lists of interested consumers with the goal of sharing information when the website functions better.
Kathleen Oestreich, CEO of the health insurance cooperative Meritus, said the website has improved since Oct. 1. Still, most people can’t complete the final steps to choose a health-insurance plan.
“We’re certainly helping people understand what the glitches are and tell them that it might be better to wait a little bit rather than become frustrated,” Oestreich said.
Oestreich said her team has discussed alternative strategies, such as filling out paper applications on behalf of consumers or enrolling by phone.
“We’re certainly keeping a very close eye on what’s going on and looking at what our alternatives may be,” Oestreich said.
Mesa broker Al Leafman has his own answer to the marketplace malfunctions. Leafman, who operates an insurance storefront in Mesa, has helped about 30 Arizona residents fill out paper applications by hand and send them by mail.
“These are people who have had trouble with the website,” said Leafman, president of Health Insurance Express.
Leafman said he started filling out paper applications two weeks ago. None of his Arizona customers has been notified that their applications have been accepted, but he expects approvals will soon trickle in.
As the federal government processes the paperwork, Leafman said his staff talks with the customer about health-insurance plans that may fit their needs.
He said that waiting period may be beneficial because it gives customers time to evaluate the confusing array of choices.
Health and Human Services officials say metro Phoenix residents can choose from 111 health-insurance plans at healthcare.gov. The rates vary, and plans are tiered in four categories based on the amount of coverage. A bronze plan covers 60 percent of costs; silver, 70 percent; gold, 80 percent; and platinum, 90 percent. “Catastrophic” plans will offer bare-bones coverage.
Leafman said consumers need to consider more than just cost and coverage options. Several plans marketed in Arizona, for example, have a narrow network of health providers that limit which doctors or hospitals a consumer may choose from.
“Half the process is qualifying people, but half the process is understanding the plans,” Leafman said.
Rosemary Dominguez, 57, of Ahwatukee Foothills, turned to Leafman’s company for help after repeated attempts to sign on to healthcare.gov were unsuccessful. She completed her profile with a user name and password, but was stymied when she attempted to provide more detailed information to verify her identity.
“I called the call center, and they told me to try early in the morning or late at night,” Dominguez said. Those attempts failed, too, she said.
“I just got frustrated when I continued to get locked out,” she said.
Dominguez said she filled out an application with Leafman’s help. She believes she will be eligible for subsidized health insurance because she is currently unemployed.
Elizabeth Arant, 31, of Scottsdale, estimates she has attempted to enroll more than 50 times since Oct. 1. She has tried to sign up at all hours of the day and night, but she has been unsuccessful. She also has tried to call marketplace operators and use the website’s chat feature. Nothing has worked.
“I’m giving up for a few weeks due to frustration and will try again in November,” Arant said.
While the Obama administration initially cited the flood of visitors as the culprit for the website’s problems, Obama and others have acknowledged the marketplace has technical challenges.
The Obama administration on Wednesday met with the top executives of 14 health-insurance companies to address the ongoing computer glitches. White House representatives and insurance-industry executives discussed how to make sure critical forms relayed correct information about applications and coverage options and formulated strategies to break the bottleneck of consumers seeking to buy policies online.
Top executives of most major health-insurance plans that will sell policies in Arizona — Aetna, Humana, Blue Cross Blue Shield and Health Net — were among the participants.
The White House said in a statement that “alpha teams” of technology experts from the Centers for Medicare and Medicaid Services and the private insurance companies met and discussed strategies to fix the technical problems.
Among the problems identified are obscure “834” forms that are transferred from computer to computer. Insurers have told White House officials that those forms have reported incorrect information, which could ruin efforts to sign up consumers or assign the wrong insurance plan to an individual.
The White House said in a statement that the meeting among insurance executives was “another way we are ensuring that we are doing everything possible to address the technical issues to ensure that all the American people who need it can purchase the affordable health care coverage made available as a result of the Affordable Care Act.”
Health and Human Services officials also said that they soon expect to address an enrollment glitch that will ensure people are not fined if their applications are still being processed as of March 31.
Because applications take about two weeks to process and health-insurance companies typically start coverage on the first of the month, some worried that individuals could be fined if they do not sign up by Feb. 15. HHS officials said Wednesday that they will soon issue clearer guidelines on the deadline.
“The individual-mandate timing has not changed,” HHS spokesman Fabien Levy said. “The deadline for signing up for insurance is March 31.”
Reach the reporter at ken.alltucker @arizonarepublic.com or 602-444-8285.