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HealthCare.gov improving, but still not perfect

Monday, December 9, 2013 | 6:00 a.m. CST; updated 5:24 p.m. CST, Monday, December 9, 2013

COLUMBIA — Since the Dec. 2 relaunch of HealthCare.gov, navigators in Missouri say the website is significantly easier for people to use, despite remaining errors. 

One of the most common issues they’ve had to face isn’t technical, but rather helping people who don't have email addresses or can't remember their password.

"Web-savvy people have a far less chance of having an issue," said Jeremy Milarsky, the navigator program manager at Primaris in Columbia. "I had a client who recently had surgery and his memory is not what it used to be because of the surgery. He’s disabled. For somebody like that to be expected to remember a username and password is a big thing to ask."

Navigators step in to help people who have difficulty navigating the website themselves to sign up for insurance, so Milarsky said he can’t speak about problems people who haven’t called them have encountered.

Aaron Swaney, a certified application counselor — another name for a navigator — at Family Health Center, described meeting with one woman whose troubles came from not having an email address.

"We made her an email account, did a marketplace application, compared plans and enrolled in it — all in less than an hour," Swaney said. "When it’s working smoothly, it’s a really awesome website."

That doesn’t mean technical issues have disappeared; they're just different for different people, Swaney said.

"There’s a whole flock of things that could go wrong, but fewer things are going wrong in general," he said. "For a few individuals, they’re having the same problem over and over again. That can be really frustrating."

At a conference call Nov. 30, government officials said 400 technical problems had been resolved, but officials wouldn’t say how many repairs still had to be done, according to The Associated Press.

"I think over the last couple months things have been getting better slowly, but this week has been a noticeable difference," Swaney said.

Among the improvements was the addition of window shopping, which allows people to look through plans without having to create an account.

Milarsky said many people log in about three times before choosing a plan.

"This is big stuff. This is not something that people just jump into," he said. "If you haven’t had health insurance before, something that lets you browse the plans — maybe with a notepad and calculator — is incredibly valuable. It makes sense to people."

Milarsky said since the website's launch, Primaris has helped a little more than 100 people enroll, but that enrollment is only a small portion of its services. He said the navigators have helped more than 1,000 clients by determining whether they are eligible for the marketplace, investigating issues people have had with getting Medicaid and answering general questions.

On Nov. 13, more than 100,000 people had selected plans from the marketplace and another nearly 400,000 people were found eligible for Medicaid, according to the most recent report by the U.S. Department of Health and Human Services.

National Public Radio reported that more than 1 million people successfully logged onto the marketplace on Dec. 1, and nearly as many logged on the next day. It was a big improvement from the Oct. 1 rollout, when people's computer screens froze, the website crashed and error messages popped up continuously. Many couldn't even create accounts or log in.

In a report released Dec. 1, the government estimated that more than 50,000 people can log onto the website at a time now and more than 800,000 can shop for insurance each day, according to The Associated Press.

The biggest issue right now is making sure insurance companies receive information so that people are enrolled by the Dec. 23 deadline and will have coverage starting Jan 1. According to The New York Times, the systems to deliver information to insurance companies are still flawed, so people might not be enrolled on time. Insurers are getting enrollments with incomplete, incorrect or duplicative information, The Associated Press reported.

Pros and cons

For many, that deadline can make a huge difference, like those in the Missouri Health Insurance Pool. The program was created by the Affordable Care Act to help people denied insurance because they have pre-existing conditions. That coverage ends on Dec. 31, when they are supposed to have insurance that won't deny them for pre-existing conditions.

Swaney said he encourages the people he enrolls to call the insurance companies a week after enrolling to make sure they have started processing their information.

Another big issue some officials are concerned about is the security of people's personal information.

"The security of this site and the private information does not meet even the minimal standards of the private sector, and that concerns me," said Rep. Mike Rogers, a Michigan Republican who leads the House intelligence panel, to The Associated Press. "I don't care if you're for it or against it, Republican or Democrat. We should not tolerate the sheer level of incompetence securing this site."

But Swaney said he has heard more positive than negative reactions to the website. He said even those who are paying more than they would like are relieved to have health insurance, many for the first time. Others were left speechless at how inexpensive their plan is, including one woman he met with earlier this week who is just above the federal poverty line, he said. He helped her enroll in a Blue Cross Blue Shield plan where she would have no premium each month and a maximum of $500 out-of-pocket each year.

That woman had quit smoking in the last few months, Swaney said. A woman in a similar situation but who does smoke got the same out-of-pocket maximum, but has to pay $160 each month, he said.

Milarsky said he was "cautiously optimistic" about the future of the website.

"There has not been improvement day to day, but vast improvement week to week," he said.

Supervising editor is Katherine Reed.


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