Consumers start buying insurance on Ga. exchanges
The Associated Press
ATLANTA — Consumers in Georgia started buying health insurance Tuesday on federally run electronic exchanges, one of the most prominent changes resulting from President Barack Obama's overhaul of the health care system.
Starting Jan. 1, virtually all Americans must carry health insurance or face fines. But the law also prohibits insurance companies from turning away people in poor health or charging them more money.
While Tuesday marked the first time that U.S. residents could purchase insurance coverage on the system, it was not a make-or-break deadline. The open enrollment period lasts six months and the new coverage will not take effect until Jan. 1.
Across Georgia, a network of organizations assisting people in navigating the new system were fielding questions from consumers hoping to buy coverage. Most of the consumers will qualify for tax credits to help cover their premiums.
The outreach and advocacy director of Georgians For A Healthy Future, Amanda Ptashkin, said she did not expect a large number of people in Georgia signing up on the first day. Across the country, a combination of high demand and technical glitches overwhelmed online systems early in the day. Since Gov. Nathan Deal, a Republican and opponent of the law, declined to run Georgia's exchange, the federal government assumed the responsibility.
"There's no real rush," Ptashkin said. "Coverage starts on Jan. 1. ... They can take some time, a day, a week to really feel comfortable. They don't have to feel pressure to enroll right away."
The number of callers phoning the Center For Pan Asian Community Services, which is offering consumer assistance, has picked up, said Peter Yang, a program coordinator. The center will assist anyone seeking information about their health care options, but it specializes in outreach to metro Atlanta's Asian community, including those who need translation assistance.
Apart from typical questions about health care, immigrant families have specific questions about how their residency status affects eligibility.
More than 200 people stopped by a table at Grady Memorial Hospital where two advocates handed out pamphlets explaining the law and giving practical instructions on how to sign up. Hospital officials would not allow a reporter to approach anyone who stopped by the table to ask questions.
Some of those making inquiries did not have any health insurance. Others had employer-provided coverage but wanted to know if the new plans may be cheaper.
"Everybody's situation is different," said Huxie Wilkins, the Seedco program director for Georgia, which received a $2.1 million federal grant to conduct health and outreach activities. "It's about choices and people being able to make educational choices."
A spokesman in Deal's office declined comment on the exchanges and dismissed the law as "a federal issue." Deal has said previously that the law's regulations wouldn't allow Georgia the freedom to craft a true state-based exchange. He's also rejected another pillar of the law: expansion of the Medicaid insurance program to cover more low-income residents who make too much to qualify now but still don't make enough to buy policies on the exchanges.
Insurance Commissioner Ralph Hudgens also declined comment through a spokesman. Hudgens has been an outspoken critic of the law, making appearances at tea party rallies urging Republicans in Congress to refuse funding for agencies that implement the law. That has yielded a budget impasse on Capitol Hill that resulted in a partial government shutdown on Tuesday, since the House and Senate couldn't agree on a spending plan. The shutdown, however, did not affect money for the online exchanges.
A group of Democrats gathered at the Georgia Capitol late Tuesday to applaud the law and urge Georgians to take advantage of it.
Senate Minority Leader Steven Henson said the GOP roadblocks are "sad" and "pathetic." His House counterpart, Rep. Stacey Abrams, dismissed Deal's argument that the law is too expensive. She argued that new opportunities for coverage will yield a healthier, more productive population.
"When you give people the ability to take care of themselves, they will," she said.
CHICAGO — Americans got their first chance Tuesday to shop for health insurance using the online marketplaces that are at the heart of President Barack Obama's health care overhaul, but government websites designed to sell the policies struggled to handle the traffic, with many frustrated users reporting trouble setting up accounts.
State and federal agencies were working to fix the sites, which represent the biggest expansion in coverage in nearly 50 years. There should be time to make improvements. The open-enrollment period lasts for six months.
Administration officials said they were pleased with the strong consumer interest. At least 2.8 million people had visited the healthcare.gov website as of Tuesday afternoon, said Medicare administrator Marilyn Tavenner, whose office is overseeing the rollout of the Affordable Care Act. The website had seven times the number of simultaneous users ever recorded on the medicare.gov site.
But at most only a handful of people had been able to successfully enroll online through the federal website in that time period, according to two industry officials with knowledge of the situation. The officials spoke on condition of anonymity because they were not authorized to speak about the issue publicly. The number of those enrolled is expected grow as technicians tackle and resolve glitches.
In Obama's home state, dozens of people who came to a Champaign, Ill., public health office to sign up for coverage found computer screens around the room flashing an error message: "System is unavailable."
Kimberly Shockley — logging in from Houston — and Mike Weaver, who lives in rural southern Illinois, ran into the same glitch as many others: They could not get past the security questions while trying to set up their personal accounts through healthcare.gov.
"I'm frustrated, very frustrated," said Shockley, a self-employed CPA. She spent more than an hour trying to get the security questions to work without success. When she clicked on a drop-down menu of suggested security questions, none appeared. She then tried to create her own questions, but that didn't work either.
Weaver, a self-employed photographer, said he also ran into problems with the drop-down menus. And when they started working, he still wasn't able to set up his account.
"The first day of something that you know is going to have a lot of bugs, it's not that frustrating," he said. "If it was the last day to sign up ... then I'd be terribly frustrated."
Shockley has health insurance, but is looking for a better plan. Weaver is uninsured.
State-operated sites also experienced trouble.
Minnesota got its site running after a delay of several hours. Rhode Island's site recovered after a temporary crash. A spokesman for the New York Department of Health blamed difficulties on the 2 million visits to the website in the first 90 minutes after its launch. Washington state's marketplace used Twitter to thank users for their patience.
Exchange officials in Colorado said their website would not be fully functional for the first month, although consumers will be able to get help applying for government subsidies during that time. Hawaii's marketplace wasn't allowing people to compare plans and prices.
Connecticut seemed to be a bright spot, although some users reported some snags. Access Health CT sent out a tweet shortly before noon Tuesday, confirming the marketplace logged 10,000 visitors in the first three hours of operation and 22 enrollments. A family of three was the first to sign up for coverage.
California, home to 15 percent of the nation's uninsured, reported delays online and on the phone because of heavy volume. The first completed health insurance application was taken at 8:04 a.m., just minutes after the exchange opened.
In Portsmouth, N.H., Deborah Lielasus tried to sign up for coverage but got only as far as creating an account before the website stopped working. She said she expected problems.
Lielasus, a 54-year-old self-employed grant writer, currently spends about $8,500 a year in premiums and more than $10,000 for out-of-pocket expenses because she has a health condition and her only option has been a state high-risk insurance pool. She said she expects those costs to decrease significantly.
As excited as she was to sign up, she said, her anticipation was tempered by dismay over the government shutdown that was led by congressional Republicans who want to block the health insurance reforms.
"I'm really happy that this is happening, that this is being launched ... I feel like it's a child caught in the middle of a really bad divorce," Lielasus said.
The shutdown will have no immediate effect on the insurance marketplaces that are the backbone of the law, because they operate with money that isn't subject to the annual budget wrangling in Washington.
The marketplaces represent a turning point in the nation's approach to health care. The Obama administration hopes to sign up 7 million people during the first year and aims to eventually sign up at least half of the nearly 50 million uninsured Americans through an expansion of Medicaid or government-subsidized plans.
But if people become frustrated with the malfunctions in the computer-based enrollment process and turn away from the program, the prospects for Obama's signature domestic-policy achievement could dim.
"You've got to launch this thing right the first time," said Robert Laszewski, a consultant who worked 20 years in the insurance industry. "If you don't, financially you will never recover."
Neera Tanden, president of the Center for American Progress, which helped work for passage of the law, cautioned against rushing to judge on first-day performance. Numerous observers had predicted bugs and setbacks. Trained outreach workers in many states are having trouble getting the certification they need to start helping people to enroll.
In Texas, a federally funded network of "navigators" hired to help people enroll was off to a rocky start because of backtracking participants — including some cowed by the politics of the health law.
At least four regional government councils — covering more than 30 counties statewide — reversed course in the past two weeks and turned away funds that would train navigators in their areas. Local leaders described their hesitancy as a mix of uncertainty surrounding state rules and a fear of running afoul of Republican leaders.
Many states predicted that an initial surge of interest would test the online system, but they expect most people to sign up closer to Dec. 15, which is the deadline for coverage to start Jan. 1. Customers have until the end of March to sign up in order to avoid tax penalties.
Under the law, health insurance companies can no longer deny coverage to someone with a pre-existing medical condition and cannot impose lifetime caps on coverage. They also must cover a list of essential services, ranging from mental health treatment to maternity care.
Associated Press writers David Mercer in Champaign, Ill.; Kelli Kennedy in Miami; David Lieb in Jefferson City, Mo.; Kristen Wyatt in Denver; Kathy Matheson in Philadelphia; Erika Niedowski in Providence; Holly Ramer in Portsmouth, N.H.; Ricardo Alonso-Zaldivar in Washington; Carolyn Thompson in Buffalo, N.Y; Susan Haigh in Hartford, Conn.; Juliet Williams in Sacramento; Oskar Garcia in Honolulu; Paul J. Weber in Austin; Steve Karnowski in Minneapolis; and Roger Alford in Frankfort, Ky., contributed to this report.