(USA TODAY) -- Katie Busch was ready to shop for insurance last Sunday on the online
exchange the federal government set up for her home state of
Pennsylvania. It took a week for her to even set up a user name.
last week, she kept getting error messages. This Sunday, Busch was
finally able to log in and start the application. The Pottstown, Penn.,
mother of two is looking for insurance only for herself, but when she
got to the family section, hit save and continue, the system kept asking
her if she wanted to add another person.
A week after the launch
of the health insurance exchanges that are the centerpiece of the
health care law, the federal and state-run sites are working out the
bugs. Technical difficulties are keeping many people from enrolling or
even from setting up accounts. Though consumers, including Busch, are
frustrated, administration officials and state spokespeople say the
sites were overwhelmed by demand, problems are being addressed and there
will be plenty of time for people to sign up once the bugs are worked
"The tremendous interest in access to affordable health
coverage is very encouraging," says Joshua Sharfstein, Maryland's
secretary of Health. "We're hearing through the call center and
elsewhere that people are planning to stick with it until they are
The first week the exchanges were up "saw both
successes and glitches, which is consistent with what we expected," says
Heather Howard, director of the State Health Reform Assistance
Network, which provides technical assistance to 11 state exchanges.
"This was a massive undertaking."
Comparisons to the error-ridden
launch of the Medicare Part D website launch in January 2006 can go
only so far, says Howard, who was New Jersey's commissioner of Health at
the time. Back then, consumers had already enrolled in the plan, and
website issues sometimes kept them from getting their medications.
That's a far bigger deal than causing people to delay signing up for
something they have three to six months to complete, depending on when
they want coverage to start.
After all, she says, it's not like
shoe shopping: "They're not going to go somewhere else. This period is
really for people to explore."
At HealthCare.gov, which is
handling insurance sales for 31 states, browsing has gotten a bit easier
since last week. The wait times have been cut in half, says Department
of Health and Human Services spokeswoman Joanne Peters. Still, logging
in remains a challenge because of error messages such as those Busch got
and "unknown user" responses.
"The work done to increase access
to HealthCare.gov in light of the overwhelming demand is beginning to
show results," Peters said. "But we won't stop until the doors to
HealthCare.gov are wide open, and at the end of the six-month open
enrollment, millions of Americans gain affordable coverage."
continues to be high, and the federal site will shut down again at 1
a.m. Tuesday to add more server capacity, move an "over-stressed"
component from virtual machine technology to "powerful dedicated
hardware" and to make more software changes. People have been able to
enroll over the phone.
Around the state sites:
• Kentucky. The
website for the state, which has more than 600,000 people were
uninsured in 2011, got 2.6 million page views the first week it was up.
By Monday, more than 19,000 had started applications, and 6,000 had
enrolled in plans. Another 140,000 people had checked to see if they
were eligible for subsidies or for Medicaid. And 186 small businesses
had also started applications.
"All of these numbers are,
obviously, more than we expected," said Jill MidKiff, spokeswoman for
Kentucky's state health cabinet. "We've heard a lot of good-news stories
about people who were really excited - many in their 40s and 50s who
said they had never had insurance before."
• Maryland. This
state-run site also saw tremendous interest with 170,000 unique
visitors to Maryland Health Connection by noon Monday. The call center
received more than 10,000 calls, and 13,500 people created accounts. But
the site also experienced problems early on, and officials added server
capacity, made technical adjustments and made plans to update the
system software. "We are still in the ramp-up stage of this launch," the
state reminded in a statement.
• Rhode Island. In the
first three days HealthSource RI, was open, 26,039 Rhode Islanders
visited the site, for a total of 30,416 website hits. And 580 people
made it all the way through the process.
"There are still some
issues with identification verification," said Dara Chadwick,
spokesperson for HealthSource RI. "That's a problem on the federal side,
I'm being told."
About 3,000 people created accounts - or a user
name and password - but not everyone was able to get further because of
the verification issue. On day one, the state site crashed for a couple
of hours because of the "enormous volume," but they were able to get the
site back up the same day.
• New Mexico. State officials
are deferring to the federal exchange until implementing their own in
2015. However, they did set up a Small Business Health Options Program,
or SHOP. By Monday, 486 employers had begun the application process to
cover 890 people.
"This is much more than I was expecting to get,"
said Mike Nuñez, interim CEO for New Mexico Health Insurance Exchange.
"We were hoping for 1,500 to 2,000 for the whole year."
Mexico's system went live on day one, and remained in good shape for the
rest of the week, Nuñez said. Next year, they'll use the same team to
create the individual exchange.
• Washington. Officials
expected 130,000 people to sign up in time to receive coverage by Jan.
1, the state exchange received 160,000 unique visitors the first week
and 800,000 hits, said Michael Marchand, director of communications for
the Washington Health Benefit Exchange.
"I've heard, 'It sounded
too good to be true. But when I went online, I found out it was true,'"
Marchand said. "It's going to change their life."
handled public affairs for his region during the Medicare Part D roll
out, said the "bumps in the road" for Part D were the same as for the
exchange. The site, he said, is now running smoothly.
Busch, her husband has insurance through his company that is paid in
part by the state Medicaid program because their two children are on
the autism spectrum. They fear they could lose the state contribution if
she was added to the plan. She's been without insurance since the
birth of her second child two years ago and just learned she has a
genetic syndrome that requires medical treatment. But HealthCare.gov
won't let her find what insurance coverage would cost her. She tried
contacting the call center over the weekend but gave up because the hold
time was too long.
"The whole thing is nothing but a headache,"
says Busch. "I swear the computer techs must be on shutdown too. That's
how frustrated I am with the whole thing."
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