By Ashley Lopez
Florida Center for Investigative Reporting
A deluge of Floridians have visited the federal health care exchange websites, but what most people have seen are error messages. Things haven’t gotten much better in the two weeks since the websites were launched as a key piece of the Affordable Care Act. The Tampa Bay Times reported:
Week two of the online insurance exchange was still slow-going for the millions of Americans who must shop there to qualify for subsidized health insurance next year. The exchange, where private insurers are selling a range of plans, is aimed at people who can’t get coverage through their employers or the government, such as Medicare.
Americans are giving the website’s bumpy debut underwhelming reviews. Just 7 percent of Americans say the rollout of the health exchanges has gone extremely well or very well, according to an Associated Press-GfK poll. Still, plenty of Americans are giving the system a try. Seven percent of respondents reported that somebody in their household has tried to sign up for insurance through the exchanges, according to the poll.
The Obama administration declined to say how many people had been able to enroll in plans through the sites that it runs or helps run in 36 states, including Florida. States that decided to operate their own exchanges had initial glitches but have reported a steady stream of enrollments in recent days.
Administration officials have pinned most of the blame for the technology troubles on the unprecedented volume of visitors to the federal site, 3 million just on the first day. But independent experts say now a design flaw may have been the biggest problem: Consumers must create online accounts before they can even browse plans.
There has been a lot of speculation as to why the federal government would launch a website fraught with so many tech issues—especially considering that a majority of states would be relying on the federal system. NPR reported earlier this month that “procurement, the process by which governments decide which contractors to hire for various products and services,” is to blame. It is most likely a combination of the Obama administration’s claim that the website’s problems stem from an inundation of visitors and claims that bigger technical issues were not properly ironed out before the launch is to blame.
Regardless, not all states in the country are facing this problem right now, and there is an easy explanation why: they actively carried out implementation of the Affordable Care Act themselves. In Florida, however, resistance to the law has been persistent.
The New York Times reports:
First the State Legislature roundly rejected the law, refusing to create a state insurance exchange and punting it to the federal government to run the new insurance market. It also rejected $51 billion in federal funds that was available over 10 years to expand Medicaid coverage for the state’s poor. As the day neared for consumers to enroll in insurance plans, state officials announced that so-called navigators — a group assigned to help people sign up — would be barred from state health offices just like all other outside groups.
But blame this week shifted to the federal government. Its Web site remains so error-prone that the overwhelming majority of Floridians who have tried to buy affordable health insurance have had little luck. Anecdotal evidence across Florida, which has 3.5 million uninsured residents, the second highest in the country, indicated that few Floridians managed to enroll. Those who pushed past the pleas for patience often did so in the evening or early in the morning — when Web site traffic is down.
There are no official numbers yet of how many people in Florida, or elsewhere, enrolled, tried to enroll or at least perused the offerings, but were unable to do so. The Obama administration said it would release the numbers once a month.
Florida is not the only state dealing with technical logjams. The 35 other states also using the federal government’s exchange are experiencing similar problems, most of them related to a high volume of visitors and software problems. This is not the case for states like California, which organized their own exchanges.
In fact, states who created their own exchanges—which was an option for all 50 states—have been more agile and able to fix problems with their own programs.
According to The Wall Street Journal, “new state-run health-insurance exchanges have largely fixed their technical problems, marking a sharp contrast with the federal government more than a week after the centerpiece of the Affordable Care Act opened for business.”
Several states that are running their own exchanges and doing better—including Washington state, California, Kentucky and Minnesota—allow the equivalent of window shopping without creating an account. That has helped them avoid some of the volume issues that the federal government experienced after requiring people to create accounts to look at insurance rates.
Maryland, which is running its own exchange, has a similar requirement to the federal exchange. Its site temporarily crashed last week. State officials said they largely fixed that problem but were still grappling with others, including a cost calculator that they said might underestimate the out-of-pocket medical costs consumers would face.
State officials appeared to be more nimble than the federal government. California’s exchange, called Covered California, had to be taken down over the weekend for software fixes but got back up quickly.
To make matters worse, the roll out of the federal health exchange also happened simultaneously this month with a partial federal government shutdown, which has furloughed thousands of federal employees.