Business

Deadline dash: Health care sign-ups amid glitches

Posted March 31, 2014 4:43 p.m. EDT
Updated April 1, 2014 5:49 a.m. EDT

— In a flood of last-minute sign-ups, hundreds of thousands of Americans rushed to apply for health insurance Monday, as deadline day for President Barack Obama's overhaul brought long waits and a new spate of website ills.

"This is like trying to find a parking spot at Wal-Mart on Dec. 23," said Jason Stevenson, working with a Utah nonprofit group helping people enroll.

Supporters of the health care law fanned out across the country in a final dash to sign up uninsured Americans. The HealthCare.gov website, which was receiving 1.5 million visitors a day last week, had recorded about 1.2 million through noon Monday.

More than 100 people waited for sign-up assistance at Martin Street Baptist Church, in downtown Raleigh, where an enrollment event stretched into Monday evening. Some of those in line said they had tried to sign up online earlier but were frustrated by the website, while others said they were confused by the variety of health plans available and wanted someone to discuss their options with them.

Mercedes Cooper has been uninsured, and she said she was willing to wait in order to get coverage for her chronic illness.

"I am anemic, so if I have to go to the doctors because I get sick very easily, it is easy because I have insurance right there," Cooper said. "I just pay once a month and go to the doctor's office as needed."

At times, more than 125,000 people were simultaneously using the system, straining it beyond its previously estimated capacity. People not signed up for health insurance by the deadline, either through their jobs or on their own, were subject to being fined by the IRS, and that threat was helping drive the final dash.

The administration announced last week that people still in line by midnight would get extra time to enroll.

Organizers of the Martin Street Baptist Church enrollment event said they had seen the website grind to a halt a couple of times Monday.

The website stumbled early in the day – out of service for nearly four hours as technicians patched a software bug. Another hiccup in early afternoon temporarily kept new applicants from signing up, and then things slowed further as the afternoon wore on. Overwhelmed by computer problems when launched last fall, the system has been working much better in recent months, but independent testers say it still runs slowly.

At Chicago's Norwegian American Hospital, people began lining up shortly after 7 a.m. to get help signing up for subsidized private health insurance.

Lucy Martinez, an unemployed single mother of two boys, said she'd previously tried to enroll at a clinic in another part of the city but there was always a problem. She'd wait and wait and they wouldn't call her name, or they would ask her for paperwork that she was told earlier she didn't need, she said. Her diabetic mother would start sweating, so they'd have to leave.

She's heard "that this would be better here," said Martinez, adding that her mother successfully signed up Sunday at a different location.

At St. Francis Hospital in Wilmington, Del., enrollment counselor Hubert Worthen plunged into a long day. "I got my energy drink," he said. "This is epic, man."

At a Houston community center, there were immigrants from Ethiopia, Nepal, Eritrea, Somalia, Iraq, Iran and other conflict-torn areas, many of them trying anew after failing to complete applications previously. In addition to needing help with the actual enrollment, they needed to wait for interpreters. Many had taken a day off from work, hoping to meet the deadline.

The last-minute rush was expected to significantly boost the number of Americans gaining coverage under the new law, and government officials told The Associated Press late Monday that they were on track to sign up more than 7 million Americans for health insurance by the deadline.

The insurance markets, known as exchanges, offer subsidized private health insurance to people who don't have access to coverage through their jobs. The federal government is taking the lead in 36 states, while 14 other states and Washington, D.C., are running their own enrollment websites.

New York, running its own site, reported more than 812,000 had signed up by Sunday morning, nearly 100,000 of them last week. More than 200,000 people in North Carolina have signed up through the federal exchange.

However, it's unclear what those numbers may mean.

The administration hasn't said how many of the 6 million people nationally who had signed up before the weekend ultimately closed the deal by paying their first month's premiums. Also unknown is how many were previously uninsured – the real test of Obama's health care overhaul.

In addition, the law expands coverage for low-income people through Medicaid, but only about half the states have agreed to implement that option. North Carolina is not among them.

Cheering on the deadline-day sign-up effort, Health and Human Services Secretary Kathleen Sebelius planned to spend much of the day Monday working out of the department's TV studio, conducting interviews by satellite with stations around the country.

Though March 31 was the last day officially to sign up, millions of people are potentially eligible for extensions granted by the administration.

Those include people who had begun enrolling by the deadline but didn't finish, perhaps because of errors, missing information or website glitches. The government says it will accept paper applications until April 7 and take as much time as necessary to handle unfinished cases on HealthCare.gov. Rules may vary in states running their own insurance marketplaces.

The administration is also offering special extensions to make up for all sorts of problems that might have kept people from getting enrolled on time: Natural disasters, domestic abuse, website malfunctions, errors by insurance companies or mistakes by application counselors.

To seek a special enrollment period, call the federal call center toll-free at 1-800-318-2596, or call a state marketplace and explain what happened. It's on the honor system. If the extension is approved, that brings another 60 days to enroll.

Those who still don't get health insurance run the risk that the Internal Revenue Service will fine them next year for remaining uninsured. It remains to be seen how aggressively the penalties called for in the law are enforced.

Also, the online exchanges don't have a monopoly on health insurance. People not already covered by an employer or a government program can comply with the insurance mandate by buying a policy directly from an insurer. They'll just have to pay the full premium themselves, although there may be an exception to that rule as well in a few states.

Supporters of the law held their breath early Monday when the website was taken down.

Administration spokesman Aaron Albright said the site undergoes "regular nightly maintenance" during off-peak hours, and the period was extended because of a "technical problem." He did not say what the problem was, but an official statement called it "a software bug" unrelated to application volume.

In Oakton, Va., enrollment counselor Rachel Klein said she noticed the website was running slowly.

"We all came into it understanding that today was going to be challenging," said Klein. "We're all relieved that there's going to be a little extra time for people."

House Speaker John Boehner said Monday that Republicans remain committed to repealing Obama's law. But its supporters are wasting no time trying to shape the next open enrollment season, starting Nov. 15. The advocacy group Families USA will announce 10 recommendations Tuesday to make the system more consumer-friendly.

They range from providing more in-person assistance with sign-ups to eliminating premium penalties for smokers to aligning enrollment with tax-filing season.