It took them the better part of two months trying to get signed up through the federal health insurance marketplace, but Leo Klumpe and Diana Arb finally have health coverage.

“This is one problem we don’t have to worry about anymore,” said Klumpe, 57, who recently retired after working for the state of Kansas for 30 years, the last several at a juvenile correction facility.

The Topeka couple had the option of maintaining Klumpe’s coverage through the state after he retired. But Arb said it would have cost too much.

“Our insurance was going to cost $1,150 (a month) and it was going to leave us $150 to pay bills out of his check,” said Arb, 55, who works part-time at a senior center. “So, we couldn’t afford health insurance.”

But with help from a volunteer trained to help people shop for coverage on the marketplace, Arb and Klumpe learned they qualified for a federal tax credit because the cost of the coverage available to them was deemed unaffordable given their income. The tax credit lowered their monthly premiums to $188.
We can afford that,” said Arb, who recently was diagnosed with Type II diabetes.

Klumpe and Arb were among about 3.7 million Americans who shopped for coverage on the improved HealthCare.gov website from midnight Dec. 1 through noon last Friday and among dozens who took advantage of special counseling and sign-up sessions at the Topeka Shawnee County Public Library.

Arlene Evans lives in Florida but was visiting family in Topeka last week and heard a television news report about the help sessions. She said she didn’t have insurance and wouldn’t be looking for a policy, if the health reform law didn’t require her to have one. She said she came to the library looking for the cheapest coverage she could find.

It turned out that she also qualified for a federal subsidy.

“I found something that is going to cost me little to nothing and provide me with what I need,” she said. “If the government is going to subsidize the insurance companies then I might as well do whatever makes sense for me.”
Kansas is one of 36 states that chose to rely on the federal marketplace website rather than build their own. Many of the state-run sites have worked better, though some also have had their share or problems.
Becky Hinton, a training specialist at the library, has been supervising the sign-up sessions since the federal “marketplace” site was launched Oct. 1.

“Those October sessions were pretty awful,” Hinton said. “The November ones were a little better. Now, I think the system is working pretty well. It is much more reliable.”

Technical problems rendered the enrollment system virtually unusable in the first weeks after its launch by the U.S. Department of Health and Human Services. But by the end of November, technical teams working nearly around-the-clock had the system working well enough for President Obama to declare it fixed.

Only 371 Kansans were able to use the website to select plans in October, according to HHS. The totals are expected to be much higher for November and so far this month when federal officials release updated numbers in the next few weeks.

Linda Ochs, coordinator of a Shawnee County Health Agency outreach program that supplies volunteer enrollment counselors to groups holding sign-up sessions, also said that the website was working much better now than when it was launched.

“It’s not perfect yet. There are still some glitches,” Ochs said. “But it is improving and I think it’s only going to get better.”

While it is clear the system is working better, it’s not working for everyone. John Adame, a 61-year-old retiree from Topeka, said he has been trying for weeks to sign up for coverage.

“Each time we get to the end, it (the system) doesn’t let us sign up and tells us to try again in 24 hours,” Adame said. “We’ve been doing that day after day and it just keeps telling us, try again, try again.”

Technicians working to fix the site recently added a reset button to help people such as Adame who have started applications but can’t get through the system. The feature allows users to delete applications and start from scratch, which Ochs said was frustrating but often the best thing to do.

“Our navigators like that feature because it allows them to help people who had gotten stuck before and are coming back for help,” said Debbie Berndsen, director of a statewide enrollment assistance program funded by a federal grant.

Big challenges remain

The window-shopping and sign-up features of the enrollment system are clearly working better.

But federal officials acknowledged last week that about 10 percent of the enrollment files that the system sends to insurance companies once a consumer selects a plan contain errors.

Sometimes the system fails to send the file — technically known as an 834 transmission. Other times it sends duplicate files. And sometimes the file it sends simply contains inaccurate information.

Julie Bataille, a spokesperson for the Centers for Medicare and Medicaid Services, which is in charge of the website, said federal teams were consulting with health insurance companies as they work to correct the date and fix the “back-end problems” with the system.

We’re working to reconcile that information so that all consumers who applied are able to successfully access their coverage,” Bataille said during one of her recent daily briefings for reporters across the country.

As designed, the enrollment system was supposed to allow consumers to pay for their new plans online. But that is still not possible for most consumers because of the “back-end problems.”

So, even though insurance companies are contacting consumers to complete transactions, purchasers also are being urged to get in touch with the company they selected and check that the files forwarded through the system contained the correct information.

“Everyone should follow-up just to confirm,” Berndsen said. “They should err on the side of caution.”

Nearly 190,000 uninsured Kansans are expected to purchase private coverage through the marketplace, according to an analysis by the Kansas Health Institute, the parent organization of the KHI News Service.

Because it took nearly two months to fix the enrollment website, groups working with consumers are concerned that many won’t be able to meet a Dec. 23 deadline for purchasing coverage that goes into effect Jan. 1, 2014. Those concerns have led members of Congress — both supporters and opponents of the reform law — to call for extensions or delays in assessing tax penalties against those who fail to purchase coverage.–By Jim McLean,
KHI News Service