The federal Patient Protection and Affordable Care Act's online Health Insurance Marketplace, where folks can shop for personal health care plans, came online on Oct. 1 -- at least in theory. In practice, though, the website has been fraught with problems. Ten days after Healthcare.gov was unveiled, Alaskans report little progress in signing up for health care coverage. But is a swamped system a good sign for Obamacare? Or a death knell?
"We haven't enrolled one person yet," Joan Fisher said from her office at Providence Hospital in Anchorage on Tuesday.
Fisher has been trained as a "navigator" for United Way, undergoing 20 hours of rigorous training to help Alaskans figure out their options and obligations under the new health-care law. Her training exists thanks to a roughly $300,000 federal grant to the non-profit organization. United Way hopes to use its trained health-care workers to sign up 10,000 uninsured residents in the Anchorage bowl -- about a fifth of an estimated 49,000 uninsured people in Alaska's largest city. That figure includes Alaska Natives, who have access to health care coverage through tribal clinics, Fisher said.
But with the website down, there's little navigators can do. Fisher has been fielding phone calls and making appointments, but overall she says "it's been pretty boring."
Glitches, time-outs and patience
The biggest problem? The website tells people to wait ... and wait ... and wait. Or, the system times out, and people lose their place in the questionnaire process.
Andrew Sheeler in Ketchikan wrote via Twitter that he "tried, and failed (to sign up), many times. Keep running into either loading errors or 'user name or password not found' messages. I've pretty much been trying every other day. I even resorted to making a second account, to no avail. Still trying."
Fisher is advising people to hold off for a few weeks until the glitches are worked out. "I've been trying to get enrolled myself. It's very frustrating," she said.
Fisher also said response from Alaskans hasn't been overwhelming, but she expects phone calls and appointments to increase in the months ahead. The slow response is partly "frustration with the computer, and partly it's that people aren't plugged in yet."
In Fairbanks, Shannon Skaug, director of clinical operations at the Interior Community Health Center, said her clinic has also not been able to sign anyone up yet. "The website isn't allowing it," she said.
Her clinic has fielded 20 to 30 phone calls in the last couple of days. Skaug expects that those calls will pick up in the months ahead. "I think people are probably holding off" until the federal shutdown standoff resolves itself, she said.
Cherise Fowler, outreach and enrollment coordinator at the Alaska Primary Care Association in Anchorage, said that she is busy with inquiries, phone calls and emails. But the two attempts she has made to sign people up have failed.
Nancy Merriman, executive director with Alaska Primary Care Association offered her experience: "I personally was able to get on the website over the weekend. It appears that there might be some flexibility in off-hours."
Susan Johnson, regional director with the U.S. Department of Health and Human Services, said that glitches in the system were anticipated, but the "great demand is overwhelming." That means a lot of people are interested in health care coverage -- a positive sign, regardless of any early problems. Technicians are working around the clock to fix the system, Johnson said.
The Washington Post cites repeated warnings from insurers, health care officials and even Democrats in support of Obamacare that the federal exchange was not ready to be rolled out on Oct. 1. But White House strategist David Simas told the Washington Post the volume and demand far exceeded expectations. The White House says 8.6 million unique visitors logged into the website in the first three days.
The swamped system is akin to what Massachusetts experienced in 2006, when then-Gov. Mitt Romney signed into law a bill that essentially was the state-level equivalent of the Affordable Care Act, Mother Jones reports. In the weeks that followed, the health care website and offices were overwhelmed. Yet glitches were ironed out in following months, and today Massachusetts has the lowest rate of uninsured citizens (4 percent) of any state in the nation.
For now, what were suggesting is that people go through the 800 number (800-318-2596) and get assistance, Johnson said. The website Valuepengiun can also offer some advice on whether a person qualifies for federal subsidies on health care plans.
Outreach efforts to help people sign up for health care are just beginning in Alaska, with the United Way and Alaska Native Tribal Health Consortium fielding calls, drafting brochures and holding workshops on the legislation. Insurance consultant Northrim Benefits Group has also set up Enroll Alaska to help people work through the process. They, too, have been unable to sign people up on the Healthcare.gov website, chief operating officer Tyann Boling wrote via email.
And despite intense growing pains for the website, there's plenty of time to sign up for the health care plans, which in some cases offer generous subsidies for individuals and families. People have until Dec. 15 to get coverage that starts Jan. 1, 2014, and until March 31, 2014 to avoid any tax penalties.