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| White House press secretary Jay Carney answers a question during the daily press briefing, Monday, Dec. 2, 2013, in the White House briefing room in Washington. Carney answered questions on the ongoing rollout of the Healthcare.gov website. |
WASHINGTON
(AP) -- President Barack Obama's new and improved health care website
faces yet another test in just a couple of weeks, its biggest yet. If
HealthCare.gov becomes overwhelmed by an expected year-end crunch, many
Americans will be left facing a break in their insurance coverage.
Until
now, the main damage from the website's technology woes has been to
Obama's poll ratings. But if it chokes again, it will be everyday people
feeling the consequences.
Some of those at
risk are among the more than 4 million consumers whose individual
policies have been canceled because the coverage didn't comply with
requirements of the new health care law. A smaller number, several
hundred thousand, are in federal and state programs for people whose
health problems already were a barrier to getting private insurance
before the overhaul.
"The chances are almost
100 percent that someone who would like to continue coverage next year
and intends to secure it is not going to be able to do it," said Mark
McClellan, who oversaw the rollout of the Medicare prescription drug
benefit under President George W. Bush.
"It's
important to recognize that none of these programs are going to work
perfectly from the start and a big part of implementation is having
mechanisms in place that anticipate problems and help mitigate their
effects," added McClellan, now a health care policy expert with the
Brookings Institution think tank in Washington.
But
on Monday, administration officials projected renewed confidence that
they're on top of things. White House spokesman Jay Carney declared that
the federal site serving 36 states got 375,000 visitors by noon.
Even
as fixes continued on back-end features of the system, enrollment
counselors said the consumer-facing front end was working noticeably
better - but still was not free of glitches or delays. As Carney
acknowledged, some of Monday morning's visitors were shuttled into a
queue and advised when to return for speedier service. That's actually
an improvement to handle high volume, he said.
In
the central Illinois city of Mattoon, enrollment counselor Valerie
Spencer said she and her team finally signed up their first person in
the days leading up to Thanksgiving. Now they have a half-dozen success
stories and dozens of consumers with appointments to finish applications
at the Sarah Bush Lincoln Center, a small hospital serving the region.
The
health care law offers subsidized private insurance to middle class
people who don't have access to job-based coverage. The White House is
aiming for 7 million people to enroll for private plans through new
state-based marketplaces also called exchanges. Low-income people will
be steered to an expanded version of Medicaid in states accepting it.
People have until Dec. 23 to sign up for coverage that starts on Jan. 1.
"It's crunch time and a lot of people are really nervous," Spencer said.
An
even bigger enrollment surge is expected the first part of next year,
ahead of a March 31 deadline to avoid the law's tax penalties for those
who remain uninsured.
In Beverly Hills, Fla.,
north of Tampa, self-employed real estate appraiser Tom Woolford said he
was finally able to get all the way through the process Sunday and
enroll in a Blue Cross Blue Shield plan. Except nothing happened when he
clicked a link to pay his first month's premium.
"As
far as I know, I am in orbit someplace and nobody's got a transponder
on me," said Woolford, who was otherwise pleased with the plan and his
costs. He'll give it a week and see if the health plan reaches out to
him.
If consumers still have unresolved issues, so do the feds. Among them:
THE BACK ROOM
Private
insurers complain that much of the enrollment information they've
gotten on individual consumers is practically useless. It is corrupted
by errors, duplication or garbles. Efforts to fix underlying problems
are underway, but the industry isn't happy with the progress and is
growing increasingly concerned.
Over the
weekend, as government officials trumpeted improvements to the website,
the leading industry trade group pointedly called attention to the data
mess. The president of the largest health insurance trade group said the
website fix won't be complete until the entire system works from end to
end. Karen Ignagni, president of America's Health Insurance Plans,
raised the prospect that consumers might not be able to get access to
needed benefits Jan. 1.
"There really needs to
be an intense focus now on the back end of the process," said Joel
Ario, who oversaw initial planning for the insurance marketplaces in the
Obama administration and is now a top consultant with Manatt Health
Solutions.
Administration spokeswoman Julie
Bataille said that's already happening. More than 80 percent of
insurers' problems were due to one bug that affected Social Security
numbers, she said. That's been fixed.
CRAFTING A NEW PITCH
Largely
because of the federal website problems, major advertising campaigns
encouraging everyone from the young and hip to the middle aged and
health conscious to enroll have been put on hold.
The
worry now is that the technology debacle may have done lasting harm to
the outreach plan. And even a revamped website with new bells and
whistles is going to have to compete for attention with the year-end
holidays.
"The real question in my mind is can
they turn around the messaging?" said Caroline Pearson, who is tracking
the overhaul for Avalere Health, a market analysis firm. "They've had
eight weeks of terrible press. Can they begin to reach out with a
message of things are fixed and we're back on track?"
It's unclear how much candor will creep into the pitch. Some enrollment counselors feel a need to acknowledge the problems.
Looking
back on the weeks of failed attempts to enroll people through the
marketplace, Spencer, in central Illinois, laments the feelings of
broken trust.
"We told them we were here to help them and we (couldn't) help them," she said.
Still,
some people returned again and again to keep trying to get through the
process. "They keep trusting us and they keep coming back," Spencer
said.
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