By Jamey Dunn
Since the online insurance exchange, a key piece of the federal health care reform law, was launched in October, fewer than 2,000 Illinoisans have chosen insurance plans through the Internet marketplace.
The U.S. Department of Health and Human Services (HHS) released enrollment numbers today for the insurance exchange, which is an important part of the federal health care law known as Obamacare. The statistics also included state-run exchanges. Nationwide, 106,185 people have selected plans. In Illinois, the number is 1,370. However, 30,901 have completed applications seeking information on coverage for 56,636 people. According to HHS, 11,603 Illinoisans have been deemed eligible for federal subsidies to buy insurance, and 19,447 have been deemed eligible for Medicaid.
HHS Secretary Kathleen Sebelius said during a conference call announcing the numbers today that the federal exchange has had 28.6 million unique hits since its launch on October 1.
“In every part of our country, Americans are very interested in the affordable health coverage that’s being offered through the marketplace and through Medicaid.” But the website has been unable to meet that demand, and users have been greeted by slow load times and crashes. Sebelius has apologized for the problems and said HHS is “working 24/7” to fix the problems. She admits that things are still not working as well as hoped but said that the goal is to have the site fully operational by the end of this month for the “vast majority” of users. “We are clearly, here on the 13th of November, not where we want to be on the 30th of November.”
The department has sent emails to users who tried to create an account previously, asking them to come back and give it another shot. However, one reporter participating in the conference call said he was unable to create an account when he tried. I was also unable to create an account after trying for more than an hour. HHS staff said that our experiences were isolated incidents, which were not necessarily indicative of the majority of consumers’ experiences with the website. “It is getting better. It’s getting better everyday. So I would urge people to visit the site,” Sebelius said.
Contrasting that positivism are the descriptions opponents use to characterize the rollout of the exchange. U.S. Rep. Aaron Shock, a Republican from Illinois, called it an “unmitigated disaster” yesterday. “This was a monumental mistake to go live and effectively explode on the launch pad,” U.S. Rep. Darrell Issa, a Republican from California, said during a recent congressional hearing on the rollout. House Republicans have voted more than 40 times to repeal the law, and many refused to vote for a federal budget unless Obamacare was defunded or the mandate that individuals get insurance was delayed. That stance led to the more than two-week shutdown of the federal government in October.
Opponents say that if not enough people — especially the young and healthy, who will help to balance out the costs of older people and those with preexisting conditions — sign up, Obamacare could be doomed. “At the current pace, it would take Illinois more than 14 years to reach its 2014 target,” Naomi Lopez-Bauman, director of health policy for the Illinois Policy Institute, said in a prepared statement. “This low level, whether attributed to website obstacles or lack of demand, is a cause for alarm for two reasons. First, if these enrollment trends continue, the exchange will almost certainly face an insurance death spiral, where older and sicker patients are far more motivated to enroll, driving up prices further.
Second, the number of people losing their health insurance coverage in the individual and small group markets as a result of Obamacare could leave the state with a higher uninsured rate.”
But Sebelius said today that there is no cause for alarm. She noted that HHS, state entities and community groups working to educate people about their options under Obamacare and encouraging them to get insured are “only a month into a sustained six-month enrollment and outreach effort.” Sebelius pointed to the enrollment pattern of the Massachusetts state exchange, upon which the federal concept is modeled. Under that state’s plan, many residents waited until later in the enrollment period to sign up. “I think what we saw in Massachusetts is that people visited the site multiple times before they made a decision.” She said that people want to take time to think over their choices, talk to their families and make sure that their doctors will be in the provider networks for their new plans. “We have every reason to expect more people will enroll.” Those who want their insurance to kick in by January 1 must sign up by December 15. The enrollment period ends on March 31. The uninsured face a potential fine after that point under the individual mandate. There are exemptions for religious objectors and those who cannot afford insurance.
Illinois’ exchange is run as partnership between the federal government and the state. Illinois officials echoed Sebelius’ take on the enrollment numbers. “We have consistently urged Illinois residents to take their time getting educated, rather than make an impulsive decision on something as important as health care for themselves and their families,” Jennifer Koehler, executive director of Get Covered Illinois (the state's exchange portal), said in a prepared statement. “When healthcare.gov is ready to handle more users, we expect to see more website traffic to Get Covered Illinois and significant growth in our enrollment numbers.”