Thread: Enrollment surge overcomes glitches to hit 7 million

Enrollment surge overcomes glitches to hit 7 million

Jayne O'Donnell, Aamer Madhani and Ray Locker, USA TODAY11:36 p.m. EDT March 31, 2014


(Photo: Joe Raedle, Getty Images)

WASHINGTON — A surge of interest and last-minute technical glitches marked the final day of enrollment in health insurance through federal and state websites Monday, as a target once thought out of reach — 7 million enrollees — was on the verge of being reached.

Late Monday, a government official told USA TODAY that 7 million people would sign up for insurance by the midnight deadline. The official spoke on condition of anonymity because officials were not authorized to speak before the enrollees were all counted.

It is likely to be weeks before there is a final, official tally of how many people signed up for insurance under President Obama's signature Affordable Care Act as the administration has said will continue to work with late arriving applicants to get them covered.

Last week, Obama said 6 million people had enrolled in health insurance, and the number of sign-ups continued to rise over the weekend and into Monday.

The 7 million target was reached despite a series of glitches that stuck Monday. The federal HealthCare.gov website went down early Monday for four hours for what Health and Human Services Department officials called routine maintenance. Outages and intermittent delays hampered customers throughout the day, as more than 2 million people visited the site and more than 1 million had called the call centers by 8 p.m.

At one time, HHS spokeswoman Joanne Peters said, more than 125,000 people were using the site simultaneously. Officials with the federal and state exchanges said those who tried but couldn't complete the enrollment process would be allowed to finish this week and still be considered to have met the deadline. Users of the federal site just need to show they made a "good faith" effort to enroll to get an extension.

"We have been completely overwhelmed," said Liz Lee, community impact director for United Way, from her office in Cocoa, Fla. "We got to the point where we were booked up solid two weeks ago."

In Connecticut, customers who were unable to get through to the state site were asked to call a toll-free number and leave their contact information so they could complete their enrollment this week, said Kevin Counihan, CEO of the state's insurance exchange.

Despite the problems Monday, White House reaction was positive, said Jay Carney, Obama's press secretary.

"There has been a remarkable story since the dark days of October and November, which has resulted in a situation where here on the last day of enrollment we're looking at a number substantially larger than 6 million people enrolled," Carney said.

Monday's surge and delays mirrored those on Oct. 1, the first day the exchanges were open. Then the federal site couldn't handle the initial crush of interest and crashed often until a "tech surge" of Silicon Valley experts worked virtually around the clock to fix the site by Nov. 30.

Since then, enrollment has risen.

The site's problems led the Congressional Budget Office, which last year estimated that 7 million people would use the exchanges to buy health insurance, to cut the estimate to 6 million last month. A decline in enrollments in February led some analysts to wonder if that goal would be met, a fear dispelled by last week's announcement.

"I daresay that there are few people in this room, including some of the folks who work in the White House, who would have predicted that we would get to that number," Carney said Monday.

The late enrollment success has not slowed the opponents of the Affordable Care Act, who unsuccessfully tried to kill it in Congress, hoped the Supreme Court would rule it unconstitutional in 2012 and passed more than 50 bills in Republican-led House to repeal it. Led by House Speaker John Boehner, R-Ohio, they have accused Obama of manipulating enrollment figures and hiding the number of people who have actually paid their premiums.

"The president's health care law continues to wreak havoc on American families, small businesses and our economy, and as I've said many times, the problem was never just about the website — it's the whole law," Boehner said in a statement. "We will also continue our work to replace this fundamentally-flawed law with patient-centered solutions focused on lowering health care costs and protecting jobs."

HHS Secretary Kathleen Sebelius said Monday that at least 80% of those who have enrolled have paid their first premiums, while California officials have placed that figure at 85%. On Monday, California reported that 1.2 million people have signed up for health insurance in the nation's most populous state.

"We are being swamped with huge interest, which is slowing down our system," said Peter Lee, executive director of California's exchange.

Health insurer Aetna has received premiums for about 80% of their newly enrolled members, said spokeswoman Susan Millerick. Cigna spokesman Joseph Mondy also estimated about 80% of people have paid their premiums.

"The welcome letters we send when we get their enrollment files processed are clear that the benefits do not begin until we receive payment," says Millerick. An incentive to pay: Consumers don't get their ID cards and detailed documents until after the payments are processed.

While the deadline passed Monday, insurance officials said the industry has plenty of work to do.

"We anticipate problems for many in the next couple of months," said Jessica Waltman, senior vice president of government affairs at the National Association of Health Underwriters, which represents insurance agents and brokers.

The big concern is the number of people who agents can't confirm actually have accounts and can establish they were actually in the queue. "It's very nerve-racking," Waltman said.

HOW MANY ENROLLED?
CBO's initial 7 million estimate was based on the number of people it believed were necessary to buy health insurance and balance out the risk pools for various health insurers. A system skewed toward older and less healthy people meant potentially higher premiums for everyone in the system.

Just like automobile and homeowner's insurance depends on the majority of people paying premiums but not making claims, so too does health insurance. The system, analysts said, relies on younger and healthier people paying into the system but not using many health services, in effect subsidizing the costs of those who do.

So far, federal records released in mid-March show, about 27% of those enrolling in insurance are younger than 35.

Insurers need "broad participation among the young and healthy," said Robert Zirkelbach, spokesman for the insurer trade group, America's Health Insurance Plans. Still, he notes, "age is not definitive." What's important is that insurers have a large number of relatively healthy to offset the sicker, and often older patients who have higher treatment costs.

"We know from the experience of several states in the '90s that tried insurance market reforms, it was incredibly disruptive, there were fewer cost savings for consumers and the number of uninsured didn't go down when there wasn't broad participation through an individual mandate for people to buy insurance," Zirkelbach said.

Still, "mix is what's most important," said Zirkelbach. "Having a balanced risk pool — young and healthy versus older and sicker — is more important than the total number of people that participate."

MEDICAID
The open enrollment period was for more than just those buying insurance on the private market. The law allowed states to expand access to Medicaid, the federal-state program for low-income Americans, to those making up to 138% of the federal poverty level.

The federal government will pay for that expansion for four years. After that, the federal share would drop to 90% and the states would have to pay the remaining 10%. But the Supreme Court decision that upheld the law in June 2012 also allowed states to choose to not expand, and about half of the states have not decided to.

So far, however, at least 4.7 million Americans have enrolled in Medicaid, either through the expanded program or by learning they qualified for the regular system.

That's particularly true in Kentucky, where Democratic Gov. Steve Beshear has enthusiastically embraced the law and Medicaid expansion.

Officials there said Monday that more than 350,000 Kentuckians have either signed up for Medicaid and private health insurance since Oct. 1.

For some, the wait and frustration proved to be worth it.

Darryl Manlove of Wilmington, Del., had meant to enroll before the deadline, but like millions of his fellow Americans, never got around to it.

The website was jammed when he met with marketplace guide Allison Russell of Brandywine Women's Health Associates, but she got him through on the phone, and Manlove found out he could get a silver insurance plan with a 94% discount.

http://www.usatoday.com/story/news/n...e-day/7126185/

More than 812K in NY sign up for health insurance

Insurance News Net (press release)

- ‎7 hours ago‎

Florida heads deadline crush to sign up for Obamacare

BY DANIEL CHANG AND PATRICIA BORNS
dchang@MiamiHerald.comMarch 31, 2014 Updated 4 hours ago

Elizabeth Hernandez, left, a navigator for the Affordable Care Act helps Giao Phan sign up for health insurance at the East Orange Community Center, Monday, March 31, 2014, in Orlando, Fla. Monday is the open enrollment deadline for signing up for insurance under the health care act.

JOHN RAOUX — AP Photo

The six-month period to enroll for health insurance under the Affordable Care Act ended Monday much as it began in October: with computer problems that prevented consumers from signing up through the healthcare.gov website.

But unlike the glitch-addled launch of the federally run website that serves 36 states including Florida, the closing day included tangible measures of success, with the Sunshine State emerging as a leader in enrollment.

Of the more than 6 million Americans who selected health plans through February, more than 440,000 were Floridians — exceeding every other state relying on the federally run insurance exchange, according to the Department of Health and Human Services.

An additional 125,000 Floridians were assessed eligible for Medicaid, the state-federal health program for the poor, HHS reported.
Many of Florida’s sign-ups came from Miami-Dade, which is home to the state’s highest number of uninsured residents.

April Washington, a regional government relations director for HHS, said Miami-Dade led Florida in sign-ups and was the nation’s second-most enrolled county as of March 15.

Yet even with those successes, questions about the health law remain. To what extent has the law reduced the number of uninsured Americans, estimated at 45 to 48 million people before October? Did enough young or healthy people enroll to balance out the sicker and older in the risk pool? And how many of those who selected a health plan have paid their first month’s premium?

Those questions may not be answered for months or longer as federal health officials analyze and release enrollment data.

But the demand for health insurance among Miami-Dade residents remained strong through Monday. At Borinquen Medical Centers, a network of federally qualified health clinics in Miami-Dade, enrollment counselors arrived at 8 a.m. Monday to find consumers waiting.

Strong interest lasted well into the afternoon, despite glitches with the federal exchange website, said Robert Linde✔, chief executive of Borinquen.

“People were coming in like a stream,’’ Linder said. “Today was the busiest day we’ve had, by far.’’

Many consumers who were locked out of the federal exchange by computer glitches were given time- and date-stamped slips with appointments to return within the next two weeks to complete enrollment, said Linder, who added Borinquen counselors have signed up about 3,000 people for health plans since October.

Under the law, enrollment ends at 11:59 p.m. Eastern time for the 36 states served by the federal exchange. The Obama administration said last week it will accept enrollment after the deadline from anyone who began the process earlier.

Fabien Levy, an HHS spokesman, said an overwhelming number of visitors Monday caused the website to trigger a system that asks consumers to leave their email address and return later to complete their enrollment.

“We are experiencing record volume on HealthCare.gov today,’’ Levy said, noting the website received 1.2 million visits through noon Monday, with more than 125,000 concurrent users at its peak through the afternoon.

Josue Maldonado, a 27-year-old student who lives with his parents in Kendall, avoided that problem by enrolling late Sunday, he said.

“The whole process, from creating a profile to finishing enrollment, took about three hours,’’ he said.

Maldonado said he waited until the final days to enroll because of the problems with healthcare.gov and to find the best policy for himself.

He chose a platinum-level plan with dental coverage, which covers 90 percent of his healthcare costs, for a monthly premium of $346✔.

Maldonado said the plan — his first time buying one — cost more than he had hoped to spend, and that he did not qualify for financial aid to pay his premiums. But his choice, Maldonado said, gave him peace of mind.

“Looking at the other plans,’’ he said, “it would seem pointless to go with a plan that was going to cost me $100 a month but with a $7,000 deductible.’’

Maldonado’s choice appeared to be the exception among Miami-Dade consumers.

According to local enrollment counselors and insurance agents, many consumers — especially those who qualified for federal financial aid — chose plans with the lowest monthly premiums.

Insurance agent Raymond Francois, one of 40 agents who teamed up to sell health plans to South Florida’s Haitian-American communities, said his Miami-Dade customers overwhelmingly chose the lowest-priced silver-level plans offered by Preferred Health Insurance and Coventry Insurance Florida.

And Mercy Cabrera and Odalys Arevalo, co-founders of insurance agency Sunshine Health Advisers, estimated their 60-plus agents have enrolled 20,000 to 30,000 people from Miami-Dade’s Hispanic communities who favored the same lower-cost plans.

But even with six months to consider options, not all eligible consumers were ready to decide on the final day of open enrollment.

Rosa Corea, who works at a plant nursery in Homestead, has been considering her choices since October, when a group of federally-funded counselors known as “navigators” met with her and 48 other workers at Plants In Design to inform them about the health law.

At the time, Corea said she was paying down a $36,000 hospital bill in $50 increments after her husband was injured in a car accident. She was not sure that her family could afford health insurance.

On Monday, she was still unsure whether to get covered or pay a fine of as much as 1 percent of her annual income.

“I'll probably do it after work,” Corea said, “but I still worry I won't be able to afford it. Health insurance would be another bill I have to take care of.’’

For those who don’t sign up by Monday and aren’t eligible for an extension, enrollment opens in November for coverage starting in January 2015.

http://www.bradenton.com/2014/03/31/...-crush-to.html