Bumpy first week for ACA signups

It has been a bumpy first week — and a somewhat surreal one — for the launch of the health care marketplaces under the Affordable Care Act, which has remained the heart of a partisan dispute that resulted in the first government shutdown in 17 years.

HealthCare.gov — the main portal for government-run marketplaces in 36 states, including Ohio — will temporary shutdown for maintenance at 1 a.m. EDT each night for a few hours this weekend after sustaining a rush from millions of visitors trying to enroll for coverage. While the computer glitches continued Friday as congressional Republicans sought to delay and defund the health care law, federal officials said people have been able to sign up for coverage.

The website will remain open for general information. By Monday, “there will be significant improvements in the online consumer experience,” U.S. Department of Health and Human Services said.

Still, many local residents expressed exasperation.

Amy Harrington of Fairborn said: “I finally made it to the account creation pages and after filling them out again and again it still says ‘account cannot be created at this time, try again in a few moments.’ It also says answers to security questions cannot be the same thing for two or more. My questions were all different with very different answers.”

In its first four days, there have been more than 7.2 million unique visitors to HealthCare.gov to learn about their options, according to HHS.

Federal officials said they do not expect to release individual state enrollment figures until next month. Yet the rollout, more than four years in the making, and its computer problems has been all but overshadowed by the federal government shutdown.

‘It hasn’t been smooth’

“It has sucked up so much of the oxygen in the room that people have forgotten that the rollout happened,” said Greg Lawson, a policy analyst for The Buckeye Institute, a Columbus-based conservative think tank. “That’s unfortunate, because it seems to have stumbled out of the gate. It hasn’t been smooth. There has been a lot of confusion, and there will be for a long time.”

Others believe the initial system overload may be a good sign for the overall success of the marketplaces. “There’s a pent-up desire to get coverage,” said Bryan Bucklew, president and CEO of the Greater Dayton Area Hospital Association. “People are curious about how it will work.”

He expects the technical issues will be resolved. “It’s not as if on Oct. 1 you flip a switch and everything is transformed.,” he said. “It’s a work in progress. It’s unrealistic to think that on Day 1 the public and businesses are going to understand it all.”

In the first year, more than 166,000 uninsured Ohioans are expected to sign up for health insurance coverage, according to the nonprofit Health Policy Institute of Ohio. The initial enrollment period runs through March 31, with coverage beginning Jan. 1 for those who enroll by Dec. 15.

For Greg Bope of Jamestown, the online process has not gone smoothly. “It won’t let me sign up,” he said. “I’ve been trying since yesterday.”

Dave Stone of Brookville, who was featured in the newspaper on Sept. 23, had the same experience. The 60-year-old respiratory therapist, who has multiple health problems, is trying to figure out if he can afford to retire. “I just spent another day on phone with ACA staff,” he said. “I couldn’t log in, and they are having volume overload.”

Sara Love of Riverside complained the system is geared toward people with computers, even though many of the uninsured don’t have access to the Internet. Love, 64, is on Medicare disability, because she is visually impaired, but she is looking for insurance for her husband.

“I think they could make it easier for people,” she said. “They should make it easier to find a phone number where people can get information. I have not seen it anywhere, and I have been watching for it.”

The couple plans to wait until next week to explore their insurance options, in the hopes that the system will be less overrun.

‘Affordable coverage?’

Bucklew said some of the confusion might have been prevented if state officials had done more to get the word out. “Ohio didn’t do our constituents any favors by not putting any marketing effort into the exchanges,” he said.

Cathy Levine, co-chair of Ohio Consumers for Health Care, said the Gov. John Kasich administration “made a deliberate decision not to obtain federal funding for outreach and consumer assistance. So the outreach will be more robust in states that are taking that initiative.”

The public was gracious about the problems, according to Levine, who helped out Tuesday with a telethon at a Columbus television station, answering questions and enrolling people for coverage.

“I was pleasantly surprised,” she said. “The response has been overwhelming. Overnight, the conversation went from ‘love it or hate it’ to, ‘How can I get more affordable coverage?’”

Levine said her biggest frustration this week was the ongoing uncertainty about whether Ohio is going to do a Medicaid expansion: “We took numerous calls from people whose income is not enough to get a subsidy on the exchange. Those people are going to remain uninsured unless the legislature acts quickly to pass Medicaid expansion or the governor exercises his authority to do an executive order.”

Despite and opening-week snafus, Levine feels more upbeat than discouraged. “It’s very exciting that so many people who were invisible in Ohio are now able to shop for affordable coverage,” she said. “I talked to all kinds of people on Tuesday — self-employed people; a woman who is getting divorced; people who are playing by the rules but don’t have affordable health coverage.”

Beware of scams

Another potential peril for new law is consumer fraud, which the newspaper first alerted the state about in May. On Friday, Ohio Attorney General Mike DeWine and Lt. Gov. Mary Taylor, warned Ohioans to guard against health care-related scams.“Scammers often pretend to be associated with the government to make their ploys seem real,” DeWine said. “We want to warn Ohio families to be on guard for potential scams and to take steps to protect themselves.”

Taylor, who heads the insurance department, is a vocal opponent of the health care law. But she said “it’s imperative Ohioans understand the facts about the ACA and the federal exchange so they can best protect themselves. Because the federal law and the exchanges are new and complicated to consumers, Ohioans should be even more cautious about potential scams and fraudulent behavior.”

Lawson said the process to implement the new law would probably have been smoother if there had been more bipartisan support. “The policy was rammed through, and it’s hard to get support that way,” he said. “It would have been better if there had been more agreement on front end. This is complicated, and there needs to be a very engaged conversation. They could have done a better job with that if there had been a bipartisan consensus.”

Despite the myriad problems with the rollout, Bucklew believes the status quo — with more than 1.5 million Ohioans without health insurance — wasn’t workable. “Doing nothing really wasn’t an option,” he said. “At the end of the day, after the exchanges went live, there were more resources and more information so that you can make decisions that are in the best interests of you and your family.”

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