The mid-term congressional election is less than two months away and some observers wonder whether the event will be all about nothing.
Nov. 30--Hundreds of thousands of uninsured Ohioans will have a "much improved" experience today on the HealthCare.gov website, where most consumers will be able to enroll seamlessly in private health plans and calculate federal tax subsidies designed to offset the cost of insurance, according to U.S. Department of Health and Human Services officials responsible for the website.
Computer software and hardware upgrades have doubled the website's computing capacity from a month ago, according to officials, who said the website can now accommodate 50,000 users at one time, as originally intended, and as many as 800,000 visitors a day.
"I'll believe it when I see it," said Julie Spinner, a 41-year-old Clayton resident who has been trying to sing up for coverage on the website for weeks. "It'd be nice if it did work. I'm losing my coverage at the end of the month, and I can't afford any interruptions because I have ongoing health issues. I need to get on as soon as possible. But so far, I've had absolutely no luck."
Spinner is among millions of consumers nationwide seeking coverage in new health care marketplaces created by the Patient Protection and Affordable Care Act and who have been frustrated by blank screens, error messages, system outages and other technical problems that have blocked them from accessing coverage through the government website.
HealthCare.gov is the main portal for enrollment in Ohio and 35 other states where the federal government is facilitating access to the marketplace, while 14 other states have launched their own marketplace websites.
Delays still expected
With some exceptions, the state-run websites have experienced fewer hiccups and higher enrollment than states utilizing HealthCare.gov, which was blamed for keeping total enrollment down in the first month after the launch of the website on Oct. 1.
Nearly 27 million Americans visited state and federal marketplace websites in October, but only about one million of those visitors were able to complete applications and find out if they were eligible for coverage, based on national and state-level figures released earlier this month by HHS. Meanwhile, just 106,185 Americans actually selected a plan in October, including 1,150 Ohioans.
"Those just aren't good numbers," said John Bowblis, a Miami University economics professor who specializes in the health care industry. "You know there are a lot more uninsured people than that out there."
Despite continued problems with the website, government officials said earlier this week that federal marketplace enrollment continues to climb at an accelerated pace, although official numbers for November will not be released until later this month.
State enrollment alone has nearly doubled from October to 150,000, up from 79,000 last month, according to the latest state marketplace figures, which showed particularly strong enrollment in Kentucky, California, Connecticut, Minnesota, and Washington.
But even with the upgrades to the federal website, government officials are not promising performance on par with the state marketplaces, instead projecting the federal website would work for about 80 percent of users by today.
"As we make these improvements, we expect to see intermittent periods when the system may be slow or not responsive. But we've made measurable progress, and we are moving forward," said Julie Bataille, communications director for the HHS' Center for Medicare and Medicaid Services.
President Barack Obama himself seemed to tamp down expectations for the website's reboot when he said that "the majority of people who use it will be able to see it operate the way it was supposed to." His language was decidedly softer than earlier proclamations by administration officials who said that by today the website would work smoothly for the "vast majority of users."
Goal remains 7 million people
Bataille said during peak periods of demand -- including the anticipated surge today -- some users will continue to encounter problems and could be bumped off the website and asked to return later.
Such delays have already prompted the Obama administration to extend the deadline for enrolling in marketplace plans from Dec. 15 to Dec. 23 for coverage beginning Jan. 1. The six-month marketplace enrollment period extends through the end of March next year. But those who want coverage to begin on the first of the year, when most old policies expire, must enroll by this month's deadline.
To that end, the government has enlisted the help of insurers and online brokers to help augment enrollment in hopes of reaching Obama administration projections that seven million people will gain coverage through the marketplaces by the end of next year.
The government is working with unnamed insurers in Ohio, Texas and Indiana on a way to better integrate insurers into the federal website's data hub to more easily facilitate direct enrollment, according to Bataille, who said the government would release more details about the direct-enrollment trial in a formal policy document.
Many insurers selling plans in the marketplace have already embraced direct enrollment but continue to have problems linking to the HealthCare.gov website.
Dayton-based CareSource said it would "welcome direct plan enrollment" as a compliment to the federal marketplace, through which it has already enrolled more than 500 new customers.
"The website is becoming more reliable. In addition, we are assisting consumers with paper and phone applications when the website is not functioning properly, or the individual is without access to on-line services," according to CareSource.
At the same time, the government has contracted with online brokers who already have working relationships with insurers to facilitate enrollment.
Mark Colwell, director of consumer marketing at GoHealth, said the company began enrolling consumers in marketplace plans directly with insurers on Sunday after some initial problems connecting to the federal website's data services hub.
"We are an official web broker entity" for the marketplace, Colwell said. "We're allowed to show HealthCare.gov plans and calculate tax credits and enroll consumers.
"We think it's a great idea to have web brokers like us assist in this effort because people need our expertise to enroll," he said. "We've gotten a pretty good volume of folks looking for insurance, and we just want to give them the best set of options and connect them with the right plan."
Kasich, Taylor want Obamacare repealed
Still, while some see the picture getting brighter, problems with functionality and delays in certain aspects of the government website continue to cast a dark shadow over the federal health care marketplace.
On Wednesday, the government announced it would postpone for a year online sign-ups for small businesses seeking coverage through the Small Business Health Options program, or SHOP, although small business can still buy SHOP insurance through a broker.
Officials said the move is intended to allow the government's marketplace team to work on improving the online experience for individuals, and they pointed out that small businesses with fewer than 25 full-time equivalent employees will still have access to expanded tax credits through the SHOP program to help offset the cost of providing group coverage next year.
Still, critics say the delay is further evidence that the key ingredient to President Obama's signature health care law was ill-conceived and poorly executed.
"The federal government's most recent announcement to once again change the rules....only further complicates an already chaotic insurance market," Ohio Insurance Director and Lt. Gov. Mary Taylor, said in a statement. "Instead of placing more challenges in front of job creators and consumers, the federal government needs to recognize what the Governor (John Kasich) and I have always said -- Obamacare is broken and should be repealed and replaced with more flexibility at the state level to address accessibility through lower costs."
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