Flood of consumer inquiries could make – or break – Obama health law

WASHINGTON — Kentucky health officials thought they might get a handful of serious shoppers when they flipped the switch Tuesday on Kynect, the new online insurance marketplace the state created under President Obama's healthcare law.

"We weren't even hopeful that a couple hundred people would apply," said Carrie Banahan, Kynect's executive director.

By the end the week, more than 16,000 Kentucky individuals and families had begun online applications to get health coverage next year.

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It has been a similar story across the country. Since the new marketplaces opened Tuesday, millions of Americans have flooded websites, call centers and insurance offices seeking information about health coverage offered through the Affordable Care Act, also known as Obamacare.

More than 8.5 million people visited the federal http://www.healthcare.gov site last week, according to officials at the Department of Health and Human Services.

California's marketplace, Covered California, had 514,000 unique visitors to its website the first day of enrollment.

Blue Shield of California said its consumer call volume more than doubled last week with hundreds of people asking about their options under the healthcare law and whether they qualified for federal subsidies.

For residents of 36 states that are not running their own online markets, the federal website is the main portal to get health coverage provided by the new law next year. Additionally, the federal call center received 406,000 calls.

Very few of those potential customers have been able to complete the process of applying for coverage. Legions have been thwarted by technical problems that repeatedly shut down many of the online marketplaces, including the federal site. And although officials probably have several weeks to fix the glitches — particularly with public attention focused on the federal government shutdown — lingering problems still threaten to make the debut a disaster.

But if the enrollment process smooths out, the unexpected initial surge of consumers may end up being the most important story to emerge from the first days of Obamacare's signature new markets.

"Clearly there is a lot of interest in getting health insurance out there," said Joel Ario, a former state insurance commissioner and Obama administration official who, like many, was surprised by the outpouring.

Before enrollment began last week, public opinion polls consistently showed that Americans remained deeply skeptical of the 2010 law and unfamiliar with many of its core provisions.

Fewer than 4 in 10 adults in a recent nationwide Gallup survey said they were familiar with the new marketplaces. Lack of knowledge was even more pronounced among the uninsured, with three-quarters saying they were unfamiliar with the marketplaces.

Obama administration officials and many state leaders have worried they would be unable to get enough consumers, threatening the viability of the markets, which depend on strong enrollment by young, healthy customers. Officials hope to enroll 7 million people next year.

The online marketplaces, one for each state, are designed to allow Americans who don't get coverage through employers to shop for health plans. Insurers selling on the markets must for the first time meet new basic standards and are prohibited from turning away consumers with preexisting medical conditions.

Millions of low- and moderate-income Americans who make less than four times the federal poverty level — or about $46,000 for individuals and up to about $94,000 for a family of four — will qualify for government subsidies to help with their premiums.

The open enrollment period lasts until March 31, though consumers who want coverage to start Jan. 1 will have to select health plans by Dec. 15. Many experts believe the real crush of consumers will come ahead of the December deadline.

In coming weeks, the marketplaces will face several critical tests.

One will be whether potential customers continue to visit them once the initial surge of interest wanes.

Another will be whether the administration can fix the numerous technical glitches that have frustrated consumers. The problems with the healthcare.gov site were so severe last week that in many states, only a small fraction of consumers appear to have been able to successfully apply for health coverage. Obama administration officials have declined to say how many people have enrolled so far.

In Louisiana, which has more than 900,000 uninsured residents, just seven people had applied for a plan from Blue Cross Blue Shield of Louisiana through the first two days of the federal marketplace.

Kentucky, which minimized disruptions on its website by using a simpler design than the one on the federal site, enrolled 4,739 individuals and families by Friday.

Obama administration officials said they were taking additional steps to expand online capacity and planned to take the site down for maintenance over the weekend during off-peak hours. "We expect that Monday … there will be significant improvements in the online consumer experience," the Health and Human Services Department said in a statement Friday.

Several information technology experts predicted there would be even more technical problems as online systems confront premium payments, changes in eligibility and other complex tasks.

"Is this just the tip of the iceberg?" asked Harold Tuck, former chief information officer for San Diego County. "There ought to have been better beta testing of the systems, and these errors wouldn't have come up."

Bill Curtis, chief scientific officer at CAST, a New York-based firm that analyzes information technology systems, said the heavy traffic probably explained many of the problems. "When you have this kind of volume, it exposes all kinds of weaknesses," he said.

Nevada's marketplace, Nevada Health Link, had 60,000 unique visitors on its first day, spokesman C.J. Bawden said.

Many visitors may be curiosity seekers, an analysis advanced by critics of the law suggested.

"I think if you subtract out members of Congress and their staff and reporters who called in those first 48 hours, the numbers will be considerably lower," Rep. Michael C. Burgess (R-Texas) told CNN last week.

But insurers such as Blue Cross Blue Shield of Kansas City have also reported significant increases in direct customer inquiries.

And the spokesman for Blue Cross Blue Shield of Louisiana, John Maginnis, said the insurer's 80-member enrollment task force has been "overwhelmed" by consumer interest.

In Kentucky, marketplace officials were equally pleased that small businesses were seeking coverage in unexpected numbers.

Banahan said the state had hoped to get about 10 businesses enrolled on Kentucky's small-business market by Christmas. By the end of last week, 178 had already started applications.

"There is just a lot of pent-up demand," Banahan said.



Levey reported from Washington and Terhune from Los Angeles.

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