Year-end signups crucial test for health care site

Posted December 2, 2013

— President Barack Obama's new and improved health care website faces yet another test in just a couple of weeks, its biggest yet. If becomes overwhelmed by an expected year-end crunch, many Americans will be left facing a break in their insurance coverage.

Until now, the main damage from the website's technology woes has been to Obama's poll ratings. But if it chokes again, it will be everyday people feeling the consequences.

Some of those at risk are among the more than 4 million consumers whose individual policies have been canceled because the coverage didn't comply with requirements of the new health care law. A smaller number, several hundred thousand, are in federal and state programs for people whose health problems already were a barrier to getting private insurance before the overhaul.

"The chances are almost 100 percent that someone who would like to continue coverage next year and intends to secure it is not going to be able to do it," said Mark McClellan, who oversaw the rollout of the Medicare prescription drug benefit under President George W. Bush.

"It's important to recognize that none of these programs are going to work perfectly from the start and a big part of implementation is having mechanisms in place that anticipate problems and help mitigate their effects," added McClellan, now a health care policy expert with the Brookings Institution think tank in Washington.

But on Monday, administration officials projected renewed confidence that they're on top of things. White House spokesman Jay Carney declared that the federal site serving 36 states got 375,000 visitors by noon.

Even as fixes continued on back-end features of the system, enrollment counselors said the consumer-facing front end was working noticeably better but still was not free of glitches or delays. As Carney acknowledged, some of Monday morning's visitors were shuttled into a queue and advised when to return for speedier service. That's actually an improvement to handle high volume, he said.

NEW website Getting on easier, but problems still exist

Kristin Perry of Wake Forest was among those who continued to have trouble logging in to the website. When she tried Monday, she was told too many visitors were on the site.

Wendy Davidson of Mount Olive said she's so frustrated with the online process that she mailed in her application for coverage. She said she is waiting until later this week to try to log on.

Health insurance agent Tony Gutierrez delayed enrolling people because of the website issues. He said he was able to enroll one woman through the site Monday, but that took an hour to complete.

"The speed has improved substantially," Gutierrez said, adding, "the farther we get into the application, the slower the response times seemed to be."

In the central Illinois city of Mattoon, enrollment counselor Valerie Spencer said she and her team finally signed up their first person in the days leading up to Thanksgiving. Now they have a half-dozen success stories and dozens of consumers with appointments to finish applications at the Sarah Bush Lincoln Center, a small hospital serving the region.

The health care law offers subsidized private insurance to middle-class people who don't have access to job-based coverage. To obtain the subsidies, people must enroll through

Experts say people who don't qualify for subsidies would be better off bypassing the website and signing up directly with insurance companies, which offer the same prices on policies offered through the online exchanges.

The White House is aiming for 7 million people to enroll for private plans through the state-based exchanges. Low-income people will be steered to an expanded version of Medicaid in states accepting it.

People have until Dec. 23 to sign up for coverage that starts on Jan. 1.

"It's crunch time and a lot of people are really nervous," Spencer said.

An even bigger enrollment surge is expected the first part of next year, ahead of a March 31 deadline to avoid the law's tax penalties for those who remain uninsured.

In Beverly Hills, Fla., north of Tampa, self-employed real estate appraiser Tom Woolford said he was finally able to get all the way through the process Sunday and enroll in a Blue Cross Blue Shield plan. Except nothing happened when he clicked a link to pay his first month's premium.

"As far as I know, I am in orbit someplace and nobody's got a transponder on me," said Woolford, who was otherwise pleased with the plan and his costs. He'll give it a week and see if the health plan reaches out to him.

If consumers still have unresolved issues, so do the feds. Among them:


Private insurers complain that much of the enrollment information they've gotten on individual consumers is practically useless. It is corrupted by errors, duplication or garbles. Efforts to fix underlying problems are underway, but the industry isn't happy with the progress and is growing increasingly concerned.

Over the weekend, as government officials trumpeted improvements to the website, the leading industry trade group pointedly called attention to the data mess. The president of the largest health insurance trade group said the website fix won't be complete until the entire system works from end to end. Karen Ignagni, president of America's Health Insurance Plans, raised the prospect that consumers might not be able to get access to needed benefits Jan. 1.

"There really needs to be an intense focus now on the back end of the process," said Joel Ario, who oversaw initial planning for the insurance marketplaces in the Obama administration and is now a top consultant with Manatt Health Solutions.

Administration spokeswoman Julie Bataille said that's already happening. More than 80 percent of insurers' problems were due to one bug that affected Social Security numbers, she said. That's been fixed.


Largely because of the federal website problems, major advertising campaigns encouraging everyone from the young and hip to the middle aged and health conscious to enroll have been put on hold.

The worry now is that the technology debacle may have done lasting harm to the outreach plan. And even a revamped website with new bells and whistles is going to have to compete for attention with the year-end holidays.

"The real question in my mind is can they turn around the messaging?" said Caroline Pearson, who is tracking the overhaul for Avalere Health, a market analysis firm. "They've had eight weeks of terrible press. Can they begin to reach out with a message of things are fixed and we're back on track?"

It's unclear how much candor will creep into the pitch. Some enrollment counselors feel a need to acknowledge the problems.

Looking back on the weeks of failed attempts to enroll people through the marketplace, Spencer, in central Illinois, laments the feelings of broken trust.

"We told them we were here to help them and we (couldn't) help them," she said.

Still, some people returned again and again to keep trying to get through the process. "They keep trusting us and they keep coming back," Spencer said.


Associated Press writers Carla K. Johnson in Chicago and Marco Mulcahy in New York contributed to this report.


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  • JustOneGodLessThanU Dec 10, 2013

    @Wood Chipper, healthcare costs are the cause of more than HALF of all bankruptcies in our country today...and the costs are increasing faster than anything else that we measure.

    Ignore this fact all you want, but it makes sense to put an end to this madness (and catch up with the rest of the developed world) and require people to take responsibility for themselves.

  • GovernmentMule Dec 2, 2013

    I'd like to know at what point in time 'health care insurance' became the single most important focal point of all life in the universe? It's all anyone discusses anymore (thanks to the constant liberal narrative).

    There actually ARE bigger fish to fry...

  • redwolfone Dec 2, 2013

    "Doing nothing isn't solving our healthcare woes" - Plenty Coups

    HAAAAAA! The DEMs walled out Pubs out when the law was being written, now they want the Pubs to clean up this disaster!. Typical! OH,.. and I bet its Bush's fault too.

    Grow up!

  • mep Dec 2, 2013

    Year end sign-ups.... just one of the MANY serious situations facing the Obamacare train wreck. If those millions of young health people dont sign up because they are frustrated with the website, and realize $95 a year is much cheaper than actual coverage.... the insurance industry is going to be swamped with massive costs due to all those new sickly folks that have signed up. And even with MUCH higher premiums for EVERYONE... the industry will likely need a govt bailout... which is in fact covered by the Obamacare law. So taxpayer dollars will be bleeding from every angle. LOL.

  • redwolfone Dec 2, 2013

    This will really fall apart when people see they will not save money, but will pay much more.

  • lessismore Dec 2, 2013

    Liberals say the GOP has not offered any alternatives to Obama Care.....lies.....dozens of alternatives have been offered but Dingy Harry will not allow them to be read or voted on......

  • Ex-Republican Dec 2, 2013

    "Some of those at risk are among the more than 4 million consumers whose individual policies have been canceled because the coverage didn't comply with requirements of the new health care law. " - Wow! You're joking right!?!?

    The Associated Press needs to go ahead and change their name to something like: Obama Press, DNC Press, OWHP (Obama White House Propaganda). This author, RICARDO ALONSO-ZALDIVAR, is definitely not a journalist. Ricardo is marketing copy writer at best.

  • lessismore Dec 2, 2013

    It's a disaster....and it will fail, just like everything else Obama has touched. But, he won't be held responsible for it...just like everything else he has been involved with...Benghazi, IRS, Fast &Firious, NSA.....he was either asleep, playing golf, or no one told him anything about anything. Those responsible will be HELD ACCOUNTABLE.....but no one ever is.

  • 5Rs Dec 2, 2013

    "Now we can focus on Aldona Wos and the DHHC mess here in NC. Someone needs to get fired." - bill15

    Right after Sebelius, Jay Carney, and all the other Washington hangers-on. Don't hold your breath.

  • 5Rs Dec 2, 2013

    It is true that many companies have websites handling far more volumes of transactions than To say the government leaders and their contract implementers were less than competent would be a no-brainer. To be surprised by this tests future credibility; with the specific people involved the results have confirmed their capability.