PPACA exchange sign-up under way with few glitches, long lines

November 16, 2014 at 05:35 AM
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(Bloomberg) — On the first day of enrollment for the 2015 Patient Protecion and Affordable Care Act (PPACA) plans, the HealthCare.gov exchange plan enrollment website was working well enough that 100,000 people submitted applications, U.S. Health and Human Services Secretary Sylvia Mathews Burwell reported.

It was a dramatic turnabout from 2013, when HealthCare.gov collapsed on its first day of business. More than 500,000 visitors logged on to the site yesterday, Burwell said today on NBC's "Meet the Press."

Users reported having some problems with state-based enrollment systems. In Washington state, for example, technical problems led managers to shut their site down temporarily for repairs. But HealthCare.gov — the enrollment system for the PPACA exchanges operated by the U.S. Department of Health and Human Services (HHS) — opened at about 1:30 a.m. New York time Saturday, and U.S. health officials reported no significant technical problems in the first 24 hours. The Obama administration is working to add an additional 3 million or more people to the 7.1 million already enrolled in plans established by PPACA — the law commonly known as "Obamacare." The enrollment period is set to end Feb. 15.

The biggest hurdle may be finding and winning over confused and frustrated consumers, many of them with bad memories of last year.

At an event yesterday, Burwell declined to say how late she stayed up overnight, waiting to see whether the site would work this year.

"We're not going to talk about that," she told reporters yesterday after observing people enrolling at a health clinic in Manassas, Va. "Between this and Ebola, there have been a lot of sleepless nights."

At the Greater Prince William Community Health Center in Manassas, officials expected at least 500 people to show up for assistance signing up for insurance. Frank Principi, the executive director, said he ran ads for two weeks on cable television, Hispanic radio and in newspapers to draw the uninsured to the event.

'Not quick'

Diego Osorio, an enrollment counselor, said it had taken him about an hour and a half to sign up his first clients of the day, a couple who had emigrated from Peru. They enrolled in a silver-level plan from Kaiser Permanente that would cost them $214 per month after a subsidy, he said.

"It's not quick," he said. "But it's quicker than last year."

Some of those waiting needed assistance with difficult family situations. Leonilda Diaz of Manassas asked Burwell directly during her news conference for help; her ex-husband, she said, had refused to provide her a document to prove she and her children qualify for PPACA coverage, she told the secretary.

"I need to have insurance no matter what," Diaz said later in an interview. "I just need to take care of myself and my kids."

Health clinic officials and Burwell's aides quickly ushered Diaz to the front desk of the center. Diaz said she had tried and failed to obtain coverage last year.

"This is a case that's a pretty specialized one," Burwell said. "We'll follow up. Let's see if we can help."

Premium increase

Americans buying Obamacare plans for 2015 can expect to pay about 3 percent more on average for the cheapest coverage — a small increase by historical standards — though premium changes vary widely by state.

Bronze-level insurance, the least expensive full- coverage plans available, will cost at least $307 a month on average for a 50-year-old nonsmoker next year, according to U.S. data released yesterday and analyzed by Avalere Health, a Washington consulting firm. The cheapest "silver" plans, the category most popular with consumers, would cost the same person $381 on average, a 4 percent increase from a year before.

Recalculate eligibility

It won't just be new enrollees using the HealthCare.gov website in coming weeks: The Obama administration has encouraged those who enrolled in 2014 to return to the site to recalculate their eligibility. Those who don't will find their 2014 insurance automatically renewed on Dec. 15, and in some cases the premiums may be sharply higher. Enrollees will also be given the same subsidy as 2014, even if their income has changed.

Enrollment events similar to the one in Virginia are being held around the country. At one in Chicago, William Carothers, an insurance broker for The Insurance Exchange Ltd., said many consumers have "preconceived notions" and little knowledge about PPACA programs.

"It's like putting pieces of a puzzle together," Carothers said.

Get Covered Illinois, the state agency working to implement the health care law, hosted 75 events yesterday aimed at reaching uninsured people, Brian Gorman, its director of outreach and consumer education, said in an interview.

"This year we are really focusing on African Americans, Latinos and millennials," Gorman said. "These are the most likely to be uncovered."

Consumer confusion

About nine of 10 uninsured people told the Kaiser Family Foundation in an October survey that they didn't know when enrollment opened for 2015. Miranda Adams, 19, a sophomore at the University of Illinois-Champaign, said her mother had reminded her to sign up.

"I had no idea until she told me," Adams said in an interview at the Chicago event. "I have no idea what the plans are or what's being offered."

In California, Peter Lee, the head of the state's health-care exchange, has been on a 21-city bus tour to promote the open enrollment period. Between stops in East Los Angeles and Santa Ana, he said he didn't expect "huge numbers" to enroll on the first day. Still, officials with the exchange, called Covered California, say they expect 1.7 million residents to sign up this enrollment period. That would be an increase of about 500,000, or 43 percent, from 2014.

"It's going to be tough," Lee said in a telephone interview. "We'd rather shoot for the stars and hit the moon than not try."

–With assistance from James Nash in Los Angeles and David Lerman in Washington.

For the very latest PPACA open enrollment breaking news, follow us on Twitter at http://twitter.com/LHPro_Health.

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