If you’ve been trying to sign up for health insurance in the new federal marketplace, you might be exasperated: technical glitches with Healthcare.gov top the list of Obamacare disasters so far. But experts say the ACA also has had some victories.
Here’s a rundown of current ACA successes and failures:
Obamacare: what’s going wrong?
1. Technical problems thwart consumers. The federal government made several blunders that led to problems for consumers trying to shop for insurance on HealthCare.gov, according to Dan Schuyler, a director at Leavitt Partners, which offers consulting on all aspects of the ACA. These problems included:
• Making consumers create an account before they can shop for plans. Plans purchased in the marketplaces don’t kick in until January 2014, so many consumers want to browse plans first. “Why would you pay for a plan three months prior to being able to use the product you purchased?” Schuyler says. Forcing consumers to sign up creates obstacles for those who just want to gather information and weigh options ahead of time, he says.
• Technological problems prevent some consumers from creating accounts and buying plans. Then, many consumers couldn’t even create accounts due to technical problems, Schuyler says: “That left a sour taste in a lot of folks’ mouths.”
However, on December 1, 2013, the Obama administration issued a statement saying that many of Healthcare.gov’s flaws had been fixed.
2. Many Americans will stay uninsured. An analysis published in the health policy journal Health Affairs predicts that about 30 million or more Americans will remain uninsured, partly due to decisions by 25 states – including Indiana, Pennsylvania and Texas – to opt out of Medicaid expansion, which would have covered more low-income consumers.
The flip side: Obamacare successes
The problems with Obamacare have gotten more attention than the positives, but experts say there’s a lot that’s going right – especially in some states that have created their own marketplaces. Here are some successes so far:
1. Consumer protections and better insurance.
Marketplace problems aside, experts say Obamacare has provided many benefits for consumers. “Signing up for insurance on marketplaces is key, but it’s only one part of what the ACA is all about,” says Rachel DeGolia, executive director of the Universal Health Care Action Network. She says major ACA successes so far include:
- The ban on insurers denying coverage to consumers with preexisting conditions – which applies to children now and to adults starting in January 2014.
- Allowing parents to keep their children up to age 26 on their policies.
- Requiring that all insurers cover preventive care without cost sharing. “It will be a lot easier for people to get check-ups before they get really sick and need expensive care,” DeGolia says.
2. State-level successes. Experts say some states are doing especially well, with few glitches and many new enrollees. Successful states include:
• Washington – The state has had a few snafus: For example, as many as 8,000 applicants might be getting an unpleasant surprise when they find out they actually qualify for a lower subsidy than they were told, according to information on the exchange website. However, by Nov. 14, the state marketplace helped enroll 98,000 residents in health insurance, including Medicaid and health plans that meet ACA standards.
• Kentucky – The Kentucky marketplace, Kynect, has been running well, experts say. Numbers released by the office of Kentucky Governor Steve Beshear show that, since opening on Oct. 1, the marketplace has had more than 500,000 unique visitors and has helped more than 60,000 people enroll in new health insurance, including Medicaid and private insurance.
• New York – The launch of the New York exchange, New York State of Health, hasn’t been problem-free: For example, one helpline phone number listing error got health insurance shoppers accidentally calling a Brooklyn cupcake shop. But the exchange enrolled almost 50,000 New Yorkers in health insurance since Oct. 1.
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Many states running their own marketplaces have avoided the biggest mistakes made by the federal government, Schuyler says. The marketplaces in states such as Washington, Kentucky and Connecticut allow consumers to shop and compare plans without setting up an account, Schuyler says. Many states also used outside vendors that offered existing, established technology platforms for the state exchanges, which helped them avoid some of the problems that plagued HealthCare.gov.
“There was not enough time to build these platforms from the ground up,” Schuyler says.
What can you do if you’re having problems signing up for health insurance?
If you’re experiencing problems shopping for or buying a plan on HealthCare.gov, you should persist, Schuyler says: “There are multiple pathways to enroll.”
Here are three steps to take to get a plan now:
• Try HealthCare.gov first to see if you can enroll that way, Schuyler recommends.
• If the website doesn’t work, get a plan by calling the HealthCare.gov toll-free call center, which is available 24 hours a day, seven days a week, he recommends.
• Or, you can get help from a qualified health insurance broker or a navigator, a professional who helps consumers with ACA-related issues, Schuyler says. HealthCare.gov offers a tool to find local help.
It’s important to find and purchase a plan sooner rather than later, Schuyler says, because you need to have your premium paid by Dec. 15 for coverage to start Jan. 1, 2014.
“I wouldn’t encourage anyone to wait,” Schuyler says.