Starting today, millions of Georgians were supposed to be able to find out whether the Affordable Care Act is going to make health insurance affordable after all. Apparently they all tried at once.
So many people tried to log into Georgia’s Health Insurance Marketplace that very few actually got in.
“Please wait” and “system is not available” messages greeted users all day on the state exchange, which is being operated by the federal government. Indeed, it was difficult to find people who actually got in and managed to move through the process.
The launch of the marketplace is perhaps the biggest moment yet for the health law, and Wednesday’s start was a disappointment to a lot of would-be shoppers.
“Totally frustrating,” said Cindy Holtzman, an Atlanta insurance broker for 22 years.
When she couldn’t get access to marketplace, she spent about two hours waiting for a representative to pop up on the marketplace’s “live chat” option. But no agent ever appeared on her screen to answer questions. She said she eventually made it through a couple of steps on the consumer site, only to be told: “The system is unavailable.”
Speaking at the White House just after 1 p.m. Tuesday, President Obama said that more than 1 million people had visited the federal site by 7 a.m., more than five times as much traffic as experienced by Medicare’s Web site. He said his administration would fix technical problems and adjust to “this demand that exceeds anything that we had expected.”
Even the law’s proponents had warned that there will be early glitches on the insurance exchanges. The Atlanta Journal-Constitution found Monday that only four “navigators” — people who are trained to assist consumers — had been licensed by the state in advance of the marketplace launch. In addition, there was no information available on Monday about the new plans’ “networks” —the list of doctors and hospitals that are part of the plan. Many patients want to keep seeing doctors they know, and they may have to go to the insurance companies’ websites to find out whether they can.
Insurers’ networks to be revealed
Some big questions will begin to be answered today: after all the hype and hard feelings, will the exchange actually work? So far, not very well. And will all sorts of consumers, from those who shop online every day to those who don’t even have a computer, be able to make it work for them?
“It’s a material, monumental change in what people get and how they get it,” said Morgan Kendrick, president of Blue Cross and Blue Shield of Georgia, the state’s largest insurer. “It’s the beginning of a new day, is the way I look at it, and it’s a big, big opportunity in the individual market.”
Another big question should be answered when the marketplace opens today: how restrictive will the networks of hospitals and doctors be?
Kendrick said consumers should not expect every hospital and doctor to be in the company’s networks when it comes to plans sold on the exchange. He also said the Blue Cross network for plans it administers for large companies will continue to offer more in-network providers than the plans sold on the exchange.
Exchange plans had to be competitively priced, he said. Since the health law requires the plans to include generous benefits, keeping prices down required insurers to limit their networks to get hospitals and doctors to agree to take lower reimbursements. Doctors and hospitals in these limited networks can expect a steady stream of business, so they might be willing to take lower payments in exchange for a higher volume of patients. Other providers might opt into the networks simply because they think it’s the right thing to do.
While the kickoff of shopping on the exchange will be most relevant to the uninsured and people who buy their own plans directly, Kendrick said everyone should tune in to what’s happening. He believes that more and more, consumers will buy health plans themselves instead of simply relying on an employer to provide one. He said the opening of the exchange today may signal the beginning of that shift.
"Regardless of where you sit politically on it, the change is the change," he said. "We believe it's our obligation as Blue Cross and Blue Shield of Georgia to be actively involved in this."
A handful of navigators
Finding help figuring out how to shop on the Health Insurance Marketplace may prove to be difficult for the 1.9 million Georgians who have no insurance today.
Georgia’s political leadership strongly opposes the law and state government isn’t helping consumers sign up for coverage.
Insurance brokers are expected to play an important role in helping consumers select the right plan. Community hospitals and other health care providers are also expected to help uninsured consumers sign up.
The federal government awarded two grants in August to help bring “navigators” to Georgia to provide in-person assistance to people who want to sign up for a plan. But few will be ready to help today. Navigators are also going to be working at federally qualified health centers around the state.
As of Monday, only four navigators had completed federal training and been licensed by the state of Georgia, as required. Another 23, however, had finished federally required training and also passed the state’s licensing test, but were still waiting to clear background checks, according to the state Department of Insurance.
The University of Georgia’s College of Family and Consumer Sciences and Cooperative Extension Service won a $1.6 million grant to place navigators in offices outside metro Atlanta.
The New York-based nonprofit Structured Employment Economic Development Corp. — better known as “Seedco” — won a $2.1 million grant to lead a consortium of Georgia partners that pledged to help consumers across the state find out about the exchange and sign up.
Seedco has had an Atlanta office since 2006 that has been primarily devoted to helping Georgians sign up for public benefits, according to a Seedco spokesman.
Its New York office gained notoriety for facing a federal civil fraud lawsuit related to its handling of a job training program. In December, Seedco agreed to pay $1.7 million to the federal government for falsely claiming it had placed 1,400 New Yorkers in jobs.
The federal case prompted Seedco to change it leadership and implement a range of rigorous internal controls, said Brian Robinson, a Seedco spokesman.
Seedco and its partners plan to train and license 21 navigators who will help Georgians sign up, as well as educating consumers about the opportunity. Polls show that the majority of Georgians do not know what the law will mean to them.
Seedco and members of its consortium said this year’s extended enrollment period means they will still have time to help Georgians one-on-one, even if all the navigators aren’t licensed as of today.
“We’re not going to reach all 1.9 million [uninsured] but we’re going to do our darndest to try,” said Amanda Ptashkin, the outreach & advocacy director at Georgians for a Healthy Future, which is a part of the consortium led by Seedco.
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