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Frustrations with health website continue [Herald-Times, Bloomington, Ind.]
[October 11, 2013]

Frustrations with health website continue [Herald-Times, Bloomington, Ind.]


(Herald-Times (Bloomington, IN) Via Acquire Media NewsEdge) Oct. 11--Delia Igo loves everything about Obamacare ... except Obamacare's online marketplace.

"I'm a huge fan of Obamacare, but it's been really frustrating trying to get on the marketplace," said the 50-year-old Igo, manager of Hoosier Family Chiropractic in Bloomington. "I can't begin to tell you how many times I've tried to get on. Sometimes I got as far as the log-on screen, but could never get past that." Igo lost her health insurance when it was determined she had a pre-existing health condition, and she credits the Affordable Care Act with enabling her to find temporary health insurance. But it will expire at the end of this year. Now she's trying -- so far to no avail -- to buy a permanent policy on the marketplace.



That marketplace, found at www.health care.gov, offers federally approved insurance plans for individuals and small employers. It's for people who do not have individual health insurance, or who don't have coverage through their employer, Medicare, Medicaid or the Healthy Indiana Plan.

But since Indiana's marketplace went online Oct. 1, Igo has been banging her head against a "virtual" brick wall. Exasperated, she finally called the federal government's 800 number at 11 p.m. Wednesday and pleaded for help. Someone took her through the application process over the phone, and told her when she got online she would be able to see it there.


"I was up all night trying and finally got logged on at 3 a.m.," she said. "But I did not see my application anywhere online. I went to a chat room and one person told me to call the IRS for help. Another told me I had to use Internet Explorer instead of Firefox. It was all very confusing." Igo is not alone. Chris Schrader, of the Schrader and Associates human resources consulting firm in Bloomington and an expert on the new health care law, correctly predicted a month ago that Indiana's marketplace would have technical glitches when it was rolled out. So far he's made 21 unsuccessful attempts to log onto the marketplace.

"On my last six attempts, I answered all the security questions and clicked to advance the screen, and each time it said it could not complete the activity and asked me to try again later," he said. "This is happening nationwide in states that are allowing the federal government to run their marketplace." Schrader said some state-run marketplaces, but certainly not all, are performing better than the federal site that is serving 36 states, including Indiana.

"Oregon said it's not yet ready to open up, Hawaii has pulled its marketplace down and said it will try to open it up in mid-November, and Maryland has put its marketplace up and down multiple times," he said. "But the marketplaces in Connecticut and Rhode Island have been functioning fairly well, and the country's best-functioning marketplace is Kentucky. I wish I would have picked Kentucky in the office pool." Scott Stowers, regional manager of IU Health Bloomington Individual Solutions, said IU Health Bloomington's 14 "navigators" have yet to help anyone actually get online because of the system's glitches.

"The system was supposed to be up and running Oct. 1, so there is a lot of confusion and frustration among people because the marketplace is still not functioning properly," Stowers said. "People are having a hard time finding answers to their questions because the critical information about premiums and deductibles and subsidies is still missing. And because each family situation is unique, things can get very complex in a hurry." Stowers said he and the other navigators have scheduled about 40 appointments with people beginning next week.

"But as of today, the marketplace is still not working, so we may recommend they do a paper application," he said. "The problem with paper applications is that you are just submitting information and you have to wait for the federal government to call you back with specific information about the various plans. And follow-up becomes more critical with paper because you have to make sure the information you mailed in was received." He said 10 of the navigators, specially trained people who can guide individuals and small businesses through the process of purchasing a health insurance plan online, are stationed at Individual Solutions in Bloomington. Two are at IU Health Bedford Hospital, and two are at IU Health Paoli Hospital.

"We plan to keep increasing the number of navigators in the weeks ahead," Stowers said. "We should have one or two at IU Health Morgan Hospital soon, and a few more at Individual Solutions, too." Design flaws? National software experts have been critical of a decision by the Obama administration to require people to create online accounts before they can browse the various plans on the state marketplaces run by the federal government. Sam Karp, vice president of programs at the California Health care Foundation, said forbidding people to anonymously browse the marketplaces is "a major design flaw." "What the federal government is trying to do is build an airplane while flying it," Schrader said. "I was shocked to hear the head of CMS (Centers for Medicare and Medicaid Services) say at a recent press conference that the federal website was built for only 50,000 concurrent users. But even so, if it was just about hits and servers, you could throw new hardware at the problem. But the coding and architecture problems are very deep and present profound challenges that are exacerbated when systems have to interact with so many disparate legacy systems to get the desired output. From a technical standpoint, this could take months to get straightened out." Schrader said in Indiana, a few enrollments are coming through the market place, but "at a trickle." "Insurers are claiming that the few applications they're getting have incomplete data, so they can't complete the contracts. I would not be surprised if a solution is not found by December that the administration will decide to re-load and re-launch it next year." Buyer beware When the Indiana marketplace becomes more functional, Schrader fears that people -- most of whom don't fully understand such terms as "deductibles" and "co-pays" -- will unwittingly sign up for plans that don't adequately address their health care needs.

He said there are four providers on the Indiana marketplace -- Anthem, Physicians Health Plan of Northern Indiana, MDwise, and CelticCare Health Plan of Massachusetts.

"The range of choice is narrowed when you look at this more closely," he said. "For example, people in this area can't buy CelticCare or Physicians health plans because they are not offered to residents south of Indianapolis." That leaves Anthem and MDwise, but he said people need to know that if they sign up for an Anthem plan, then Monroe Hospital and Premier Health care will be in-network, but all IU Health hospitals will be out-of-network. If they buy an MDwise plan, then all the IU Health facilities will be in-network.

"Those out-of-network costs will be significant," he said. "That's why people need to consider more than just the premiums." Schrader said he's concerned that people, particularly those buying insurance for the first time in their lives, will opt for the plan with the lowest premiums without fully grasping the intricacies of the policy. He said if you buy a less expensive plan you'll have more out-of-pocket expenses when you need medical care. The bronze plans cover 60 percent of expected medical costs, silver plans 70 percent, gold plans 80 percent and platinum plans 90 percent.

"If you are a person with a low income you may be tempted to buy a bronze plan, but if you are a high utilizer -- meaning you go to the doctor a lot and need a lot of medications -- then you would be better off with a silver plan," he said.

Who to call To make an appointment with an insurance marketplace navigator, call Individual Solutions at 812-353-2020 or 1-800-313-1328.

The office at 413 S. Landmark Ave. operates from 8 a.m. to 4:30 p.m. Monday through Friday, though individual appointments may be available outside of those times.

Help is also available at IU Health hospitals in Bedford, Martinsville and Paoli through the same phone numbers or by calling the hospitals.

Help on a toll-free line is available through the federal government at 800-318-2596.

___ (c)2013 the Herald-Times (Bloomington, Ind.) Visit the Herald-Times (Bloomington, Ind.) at www.heraldtimesonline.com Distributed by MCT Information Services

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