Officials from five state health exchanges agreed that the challenges have been daunting and that indications over the past couple of weeks are very encouraging, with consumers signing up for insurance at a rapidly rising rate as the deadline approaches for obtaining coverage by Jan. 1.
In a media conference call hosted Wednesday morning by Families USA, a non-profit organization advocating for health-care consumer, officials from California, Connecticut, Kentucky, New York and Washington shared their experiences.
Peter Lee, executive director of Covered California, reported that more than 450,000 Californians had completed applications, including more than 180,000 who were found eligible for Medicaid. He called the reported numbers just “the tip of the iceberg.” He reported sharp increases in applications. “In the first week of December, we had 50,000 people pick a plan in Covered California,” he said. “Last week our enrollment was tracking at about 15,000 per day. We are seeing huge interest.”
Other states reported similar jumps in applications. Richard Onizuka, CEO of the Washington Health Benefit Exchange, didn’t offer figures for December since, he noted, the numbers would have been skewed by the the Washington Healthplanfinder exchange website being down most of the first week.
But interest was extremely high, he said, reflected by call-center activity.
“Like everybody else, we’ve seen call-center volumes really, really high,” Onizuka said. “We’ve doubled the amount of staff in our call centers here but we’re still averaging high wait times, so we’re trying to do other things to manage the triage. As a perspective, we’re getting a call volume that I think California had projected for their state. For us it’s about four or six times what we had projected.”
Onizuka added that surveys have shown growing awareness of the insurance exchange. According to Onizuka, a survey in mid-November of 1,000 residents showed that 49% of respondents had heard of Healthplanfinder, way up from mid-September’s 19 percent.
The officials on the call were from states that run their own exchanges, which have had relatively smooth experiences compared with the federal exchange. There was general agreement about the biggest hurdles they have faced.
At the top of everyone’s list was the short time window available. “We all built something very quickly, but this is a huge lift,” said Covered California’s Lee. “We would’ve loved to have had six months more for user acceptance testing. We would have loved to have had six months more for training of our staff and licensing agents.”
But without final requirements from the federal government earlier in the process, that wasn’t possible. “The sequence what we’ve had is what we’ve had to live with,” he said.
In addition to the lack of time for training, Washington’s Onizuka cited the lack of time to test the interconnections between the various state and federal systems involved. “What we weren’t able to do is simulate the real-world environment,” he said. “You can’t really replicate the real-world in testing environment.”
Lee noted that recognizing the challenges faced by the state exchanges isn’t just about assigning blame. “More importantly, we and the other exchanges are learning now to make sure that next year’s open enrollment is going to be a lot better,” he said. “This is the beginning of a historic change for the marketplaces for the next generation of healthcare.”