The Health Exchange Rollout Was A Mess But Plan B Is Not So Easy

Nov 13, 2013
Originally published on November 13, 2013 7:01 pm
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From NPR News, this is ALL THINGS CONSIDERED. I'm Audie Cornish.


And I'm Robert Siegel.

The Obama administration released its first hard numbers today on how many people have signed up for health insurance through new online exchanges, and the numbers are even lower than had been reported. The administration blames a problem-plagued federal website for much of the difficulty.

But officials say the site is getting better and that they expect enrollments to pick up in the coming months. In the meantime, some lawmakers are getting nervous and are on the hunt for workarounds. NPR's Scott Horsley joins us now. Hi, Scott.

SCOTT HORSLEY, BYLINE: Good to be with you, Robert.

SIEGEL: First, how bad are the numbers?

HORSLEY: They are low, Robert. Just 27,000 people managed to complete the process of signing up for coverage on the federal website during its first month of operation. Another 79,000 signed up through state websites, so a total of about 106,000 people. That's about 20 percent of the government's original target for the month of October. Now, as you say, the White House has been saying all along they expect enrollments to start slow and pick up as we approach various deadlines in this process. That has been the experience in states like Massachusetts.

But this start is definitely slower than the administration would have liked. And, of course, a chief reason for that is that federal website that's been so hard to navigate. Health Secretary Kathleen Sebelius acknowledged as much this afternoon in a conference call with reporters.

SECRETARY KATHLEEN SEBELIUS: There's no doubt that particularly the earlier experience with was enormously frustrating. It is getting better. It's getting better every day. So I'd urge people to visit the site.

HORSLEY: While the enrollment numbers are low, the traffic on the website does suggest there's an awful lot of interest out there. If you combine the state and federal websites, nearly 27 million different people logged on to at least try to shop for insurance.

SIEGEL: Scott, the administration says it hopes to have the website working smoothly for most people, I believe it says the vast majority of Americans, in fact, by the end of November, this month. How realistic is that?

HORSLEY: Experts, both inside and outside the government, say that's an ambitious target. And we continue to hear complaints from people about trouble even taking the first step on the website, setting up an account, although the administration said today 90 percent of those going to the website are at least able to do that.

They have been promoting some workarounds, 800-numbers you can use or mail-in applications, although eventually all that paperwork still has to go through the same roadblock. Secretary Sibelius did mention another option today. People can use the shopping function on the federal website or one of the commercial sites out there. And then if they find a plan they like, they can go directly to the insurance carrier and sign up with them.

This only works, though, for people who don't expect to qualify for a government subsidy. If you're counting on that subsidy, you have to go through the government application process.

SIEGEL: Now, lawmakers have been getting pretty nervous about this as they hear from constituents who want to sign up and can't and from people who have gotten cancelation notices on their existing insurance policies. What help are they offering?

HORSLEY: Well, a variety of remedies have been proposed by members of Congress. There are a couple, for example, that would try to codify the president's promise that if you had a plan you liked, you could keep it. One would allow any private insurance plan that was sold this year to be sold next year, even if it doesn't meet the minimum standards in the health care law and is not otherwise grandfathered in.

But the problem with some of these fixes is that the people who had those private insurance plans before tend to be the healthiest people. And if you carve them out of the risk pool in the new Obamacare plans, that throws off the fragile arithmetic and could lead to higher premiums going forward. So the White House had said some of these fixes create problems of their own.

SIEGEL: That's NPR's Scott Horsley. Scott, thank you.

HORSLEY: My pleasure. Transcript provided by NPR, Copyright NPR.