Problems With Marketplace Website Force Applicants to Turn to Paper

Andrew Kitchenman | October 16, 2013 | Health Care
While navigators remain hopeful, concerns begin to grow about marketplace delays

Credit: Donnette Williams, social programs manager for Newark Community Health Centers Inc.
donnette williams
Problems with the online federal health insurance marketplace have forced New Jersey residents to revert to pen and paper when they apply for coverage.

Several agencies say they have been helping residents take the first step toward signing up for insurance by preparing paper applications that must be mailed to the federal government, while the marketplace or exchange website, remains difficult to access.

The situation is troubling health policy experts, who note that there are only two months until the December 15 deadline for residents to enroll for coverage that will start on January 1, 2014.

Joel Cantor, the director of the Rutgers Center for State Health Policy, said that while the website delays are not yet a major concern, they will become one if the site isn’t fixed soon.

“I would want to see this thing working well, certainly by the end of this month or by the very latest by the middle of November,” Cantor said. “Otherwise, I think we will have a problem with people having coverage in January.”

The marketplace, established by the 2010 Affordable Care Act, enables people who aren’t insured by their employers or through government programs like Medicare and Medicaid to purchase coverage and learn whether they are eligible for tax credits to subsidize the cost. Since its October 1 launch, the marketplace site has been difficult to access.

However, officials with nonprofit groups helping residents enroll noted that there have been improvements to the website recently. For example, residents can now get a list of the insurance plans available in their county, as well as an estimate of how much insurance will cost after subsidies.

Still, various error messages and blank screens generally greet people trying to complete an application through the site.

Donnette Williams, social programs manager for Newark Community Health Centers Inc., has been overseeing the program to enroll residents in her organization, which is one of the state’s federally qualified health centers.

Williams said the application process has been time-consuming, since many of the residents applying for coverage lack basic knowledge about health insurance. The application itself can take up to 45 minutes, not including the explanations provided by staff members.

In addition, the paper application only determines whether the resident is eligible for the marketplace insurance. Once they have received a mailed response from the federal government, they must use one of the specific health plans offered through the marketplace.

Williams said she is hopeful that the site problems will be resolved soon, allowing her staff to concentrate more on community outreach. Federal officials have not provided a timeframe for when the site will be fully accessible.

“We try it every day, because we’re waiting for the day where we can actually complete an online [application],” said Williams, noting that the problems with the website have also prevented her staff from identifying residents whose incomes make them better candidates for Medicaid.

Katherine Grant-Davis, president and CEO of the New Jersey Primary Care Association, said much work can still be done to prepare residents while the website remains down. Her association represents all of the state’s federally qualified health centers.

“Most people are in the information-seeking stage at this point,” Grant-Davis said, adding that the centers are in the process of distributing thousands of flyers about the online marketplace.

“We haven’t seen that people are frustrated at this point,” she said. “Hopefully, they will get it resolved soon. It’s only been 15 days.”

December 15 is the deadline to enroll for coverage that starts January 1, although the open enrollment period will last until March 31. But Cantor is skeptical about the website’s ability to handle a rush of applicants right before December 15.

“They haven’t shown that they can handle that, to say the least,” Cantor said.

He suggested residents interested in the marketplace wait two weeks before proceeding.

“Certainly you’re not going to get insurance any faster if you register this week vs. the end of the month,” he said.

But those looking to enroll residents are hoping to make the best of the situation.

Marion Lynch, spokeswoman for the FoodBank of Monmouth and Ocean Counties, said her organization has helped residents complete paper applications.

The organization is one of five in the state that received federal funds to serve as “navigators” to help residents enroll through the marketplace. In addition, the foodbank used the opportunity to help residents enroll in other healthcare and social programs, including some who are newly eligible for Medicaid.

She said the information that is available on the marketplace site — such as the premium and subsidy estimate — is “what most consumers want” at this point.

“Once the technical issues are resolved they can go in and sign up,” Lynch said, “and this gives people time to be smart consumers.”

Eileen Henderson, vice president for the Camden-based Center for Family Services, said her organization has focused on scheduling residents for application appointments in coming weeks, as well as participating in outreach efforts. The center is serving as the navigator for southern New Jersey.

“It’s a little difficult, but we’re hoping very soon that the volume issues are going to become more manageable,” Henderson said. “Of course, it is anxiety-producing for some of the consumers