Insurance companies share the blame for low Obamacare enrollment

I’m no fan of the Obamacare federal exchange Web site.  But it’s ridiculous for anyone to claim that Obamacare is doomed simply because as of today “only” 50,000 people have signed up for insurance via the federal exchange, with another 50,000 via the state exchanges.

I’m going to deal with the federal exchange, as Sarah Kliff has a nice write up of why the state exchange numbers aren’t that bad either.

One major reason why not enough people have signed up via the federal exchange is that the federal exchange Web site still doesn’t work.  At least not for everyone.

And the site not working tends to have an impact on the total number of people who sign up for health insurance via the site.  Now, I’m not happy that it doesn’t work, and we’ve written numerous stories about it.  But it will work eventually.  And only then can we judge whether people are willing to sign up for insurance or not.

Until the federal exchange site is fixed, of course enrollment will be low

Take my sister.  She’s in Illinois, a state that defers to the federal exchange.  I helped her create an account on the federal exchange a week ago Sunday – she was just too busy with work to try before, and all the stories about the site not working convinced her to hold of even browsing plans until now (yet another reason why the initial enrollment numbers will be low – people are waiting for things to calm down).  When we weren’t able to browse plans after creating the account (they, bizarrely, call it “applying” on the site), I called the 800 number on the site and immediately got someone who explained that it takes between 2 hours and 3 days for them to approve you to browse plans.

Now, it’s of course idiotic that anyone has to get “approval” to browse plans (yes, we wouldn’t want bad people to be able to see how much it costs to insure a 55 year old Chicagoan).  The site shouldn’t require any information beyond my sister’s zip code and birthday in order to simply show her what plans are available, and what they cost (without subsidy, of course – it’s more complicated with the subsidy).

Well, it’s been 8 days.  And my sister is still waiting for “permission” or “approval” or whatever to browse the plans on the federal exchange.  So I called the 800 number again, and they recommended just creating a new account. Which we’ll do.  But that’s the reason my sister hasn’t bought a plan yet, because the Web site doesn’t yet work.  And if it’s happening to her, it’s probably still happening to others as well.

Insurance Companies share the blame for low enrollment

But here’s another reason why not everyone who will buy plans has bought them yet.  The insurance companies aren’t doing as good a job as they could passing along information as to what the plans actually cover.

I plan on buying a plan on the DC exchange.  While the DC exchange works exceedingly well, when I called Blue Cross Blue Shield for more information I first got a woman who clearly had no idea what any of the plans contained.  After putting her to out of her misery about ten minutes into the call, I got a guy who knew a lot more, but still couldn’t explain lots of details, such as how the out-of-pocket max worked, how the plan works for providers who are out of state, and he could find no information on whether, and to what extent, the insurance covers my allergy shots.

The man on the phone told me that they had not been permitted to see the plans before the exchanges launched, so the plans were as new to the folks on the phone at BCBS as they were to me.  So again, I’m probably not the only person who called and got a confusing answer as to what the plans covered, thus convincing me to postpone buying anything for a while.

Another problem when I phoned BCBS – they couldn’t tell me what the coverage was for my allergy shots.  I get two shots per month during normal months, and more when changing medication.  Depending on whether they charge $5 a visit, or $25 a visit, is the difference between my paying $200/year versus $1,000/year for my allergy shots.  So it’s not a small question.  BCBS simply couldn’t tell me what their plan covered.  Which is ridiculous, since they were already selling the plan.  Yet another good reason not to buy the plan until BCBS can fully explain what the plan actually does.

And finally, I still can’t get a straight answer as to how my plan works outside of the DC, MD, VA area.  The plan I’m looking at is ironically called a POS (it’s a combination between an HMO and a PPO).  But Blue Cross still can’t explain how the PPO part of  it works, especially outside of my tri-state area.  I even asked my doctor’s office about it today, as they’ve investigated the plans too, and even they can’t get a straight answer as to how the PPO part of the plan works.  In my case, the fact that I still, six weeks into this venture, can’t get a clear answer from Blue Cross Blue Shield as to the details of the plan I want to purchase, has definitely delayed my decision to purchase a plan on the exchange.

I will purchase one.  I’m simply waiting for BCBS to get its act together.

All of this adds up to lots of fixable reasons why not as many people as expected have signed up for health insurance on the Obamacare federal exchange.  But as noted, the reasons are fixable.  And until the problems are fixed, the supposedly-low enrollment numbers simply tell us what we already know – that when the Web site doesn’t work, and even the insurer itself can’t tell you what’s in the plan, people are going to hold off on buying the plans.

But at some point the Web site will be fixed, and Blue Cross will learn what’s in its own plans.  And only then will we be able to look at enrollment numbers and be able to reach any meaningful conclusions.

(I’m told that in order to actually see my Facebook posts in your feed, you need to “follow” me – so say the experts.)

Follow me on Twitter: @aravosis | @americablog | @americabloggay | Facebook | Instagram | Google+ | LinkedIn. John Aravosis is the Executive Editor of AMERICAblog, which he founded in 2004. He has a joint law degree (JD) and masters in Foreign Service from Georgetown; and has worked in the US Senate, World Bank, Children's Defense Fund, the United Nations Development Programme, and as a stringer for the Economist. He is a frequent TV pundit, having appeared on the O'Reilly Factor, Hardball, World News Tonight, Nightline, AM Joy & Reliable Sources, among others. John lives in Washington, DC. .

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49 Responses to “Insurance companies share the blame for low Obamacare enrollment”

  1. poppy76 says:

    Has anybody actually sign up, paid and received insurance plan? For real?

  2. Hue-Man says:

    Each province has a separate single payer plan which does not generally cover pharma, vision, psych, physio, or the excess of foreign emergency care (to the U.S. for example) over the provincial reimbursement schedule. The employer pays the premium for these additional costs. Premiums are modest – $30/month for single employees for dental, same for pharma. Unlike provincial medicare, these supplemental plans often have patient co-pays and limits, especially dental and pharma.

  3. Mark_in_MN says:

    Supposedly the specifics aren’t being made public to protect security, but it could just as easily be so that Issa, his staff, and his ilk, can insinuate without clearly available context.

  4. Mark_in_MN says:

    The Hill is credible, and their quote of a anonymous staffer is more credible that anything that passed from the mouth of Darrell Issa. If Issa told me the sky was blue, I’d look to check for myself, thinking it must have a weird, unusual color that day, all while wondering what political game he was playing with the color of the sky.

  5. perljammer says:

    An unnamed staffer talking about an unnamed function that won’t be active until an unnamed time. That sounds credible.

  6. Mark_in_MN says:

    On the other hand that link to The Hill states:

    “A Democratic Oversight committee staffer said the security issue relates to a function of the website that isn’t currently active and won’t be until early next year.”

    The staffer goes on to point out that Congressman Issa’s press releases distort and manipulate information “to scare the public by capitalizing on confusion caused by the chairman’s own staff.” The staffer also points out that Issa didn’t bother to tell the witness who had never seen the memo that it wasn’t about features that went live on October 1.

  7. Mark_in_MN says:

    Republicans have obstructed any aspect of the Affordable Care Act that they could. The biggest obstruction here is that the law always envisioned that the exchanges would be state run, but so many states, under the sway of Republican governors and legislatures who seem bent on trying to force the failure of anything that could be connected with the President, refused or failed to create those exchanges. This has ended up putting an undue burden on the federal exchange. Note, for example, that state run exchanges have worked fairly smoothly. Further, do you think that a bill appropriating money specifically to build the federal exchange (after the initial appropriation many years ago when the Affordable Care Act was passed) actually passed the Congress and the Republican controlled house? (My understanding is that the funds to build the exchange were found within the budget and that no line item appropriation specifically funding this project was made.)

  8. Mark_in_MN says:

    The Patient Protection and Affordable Care Act requires that eligibility be confirmed for those seeking to buy insurance through the marketplace. One of those eligibility requirements is that one be a citizen, national, or lawfully present in the United States. Immigration issues are handled out of the Department of Homeland Security, so an applicant may need their eligibility checked against DHS records. I haven’t seen mention of the Department of Defense in many ACA related materials, but I would suppose that the system might check eligibility for Tricare or VA benefits, or there could be service related provisions that effect eligibility for subsidies in some cases. In most cases, the only thing that would be done would be a query based on your personal identifying information. Nothing terribly unusual there. Government agencies do that all the time (and a good deal, even if not all, of that information is actually public information, anyway). The system is a marketplace, not a repository for health records and such. The federal marketplace isn’t transmitting personal health information all over the place, since it only gets it when its necessary to determine eligibility (here probably for specific programs like Medicaid and CHIP) and enroll you into a plan. The Department of Health and Human Service and their Centers for Medicare and Medicaid Services point out that they do not store this information. The other prime agencies involved are the Social Security Administration (no doubt as part of eligibility and identity checks, as well as to be sure you’re not eligible for Medicare) and the IRS (which would be important for income verification with respect to possible subsidies). These agencies have your identifying information already, clearly, and they don’t need health information about you to provide the information and verification needed in running the exchange.

  9. Bill_Perdue says:

    “extended health insurance from a 3rd party provider “.

    Is that like a gap or supplemental plan, one that pays costs not covered by the primary?

    In this country they’re very expensive to buy and they still come with co-pays and co-insurance costs and thor help you if need expensive drugs or extended care.

  10. Drew2u says:

    Thanks, man. That $10,000 represents about 10 months worth of pay for me, not including my other bills factored in.

  11. ezpz says:

    Wishing you all the best with your upcoming surgeries and all.
    Hope it goes smoothly.

  12. ezpz says:

    “Republican obstruction?” Seriously? For a broken website that they had three and a half years to build? Surely you can do better than that, no?

  13. ariesmatt says:

    Perhaps to save money? Lowest bidder? Republican obstruction? I agree that they should have had better people working on it, but that doesn’t always come with the lowest bidder.

  14. Drew2u says:

    And Republicans cut Veterans Assistance quicker than that, so what’s your point?

  15. Drew2u says:

    You do know that minors are still able to be on their parents’ health insurance, as it always was, so why – and I’m assuming by your maturity level – were you looking on the exchange in the first place?

  16. ezpz says:

    And why, pray tell, do they have to communicate our personal information with all these govt agencies? Why the need for Dept of Homeland Security, Dept of Defense, to name just two, to know my personal and health related info?

    You may be fine with that. I’m not.

  17. Josh says:

    Spent 45m on the phone yesterday with Obummercare reps and then they told me to call back in 3-4 hours because the system was down. I called this morning and after 20m on the phone, I was told the system is STILL down. I can’t create an account online, I clearly can’t sign up via phone.

    Thanks a lot Fartbongo.

  18. Hue-Man says:

    Reading John’s story about his own insurance “bets” and the profile of many others looking to Obamacare to provide coverage for life-saving medical treatments, I’m really glad I have only one choice to make – self-insure for medical costs not covered by socialized medicine or purchase extended health insurance from a 3rd party provider (estimated 67% of Canadians are covered by employer provided extended health insurance ).

    After all the hype about the efficiency of markets and competition between insurance companies, I was shocked to see this last week: “And in 17 percent of U.S. counties – including all counties in New Hampshire and West Virginia – just one insurer has a monopoly on the
    subsidized exchanges.” (Follow the link for the stats on markets with only limited competition) For all the government bashing, I trust its monopoly much more than I trust an insurance company monopoly (or oligopoly) when it comes to matters of life and death, especially my own!.

  19. lynchie says:

    But but but he loves to make him some big speeches.

  20. Bill_Perdue says:

    Obamacare, an incestuous cousin of Romneycare, was written to make insurance companies richer and to free pharmaceuticals to continue to engage in price gouging.

    Private insurance is the wrong approach. It’s costly, and, as we’ve seen, unmanageable, volatile, capricious and hungry for profit. And, worst of all, it’s inefficient.

    Socialized medicine is the only solution.

  21. Fireblazes says:

    It is difficult to sign up when the customer service people can barely figure it out. I spent hours on the phone, finally got registered only to find no plans on the your choices page. Still nothing there a week later. In the meantime, lots of people are forced to sign up for crappy overpriced policies at their jobs.

  22. Mark_in_MN says:

    Yeah, it’s not like having to talk to all sorts of different government computer systems in different agencies, all of which have their own protocols, makes the job a challenge for any developer.

  23. tselle says:

    A woman in a hot air balloon realized she was lost. She lowered her
    altitude and spotted a man in a boat below. She shouted to him, “Excuse
    me, can you help me? I promised a friend I would meet him an hour ago,
    but I don’t know where I am.”
    The man consulted his portable GPS and
    replied, “You’re in a hot air balloon, approximately 30 feet above
    ground elevation of 2,346 feet above sea level. You are at 31 degrees,
    14.97 minutes north latitude and 100 degrees, 49.09 minutes west
    She rolled her eyes and said, “You must be a Republican.
    “I am,” replied the man. “How did you know?”

    “Well,” answered the balloonist, “everything you told me is technically
    correct. But I have no idea what to do with your information, and I’m
    still lost. Frankly, you’ve not been much help to me.”
    The man smiled and responded, “You must be an Obama-Democrat.”
    “I am,” replied the balloonist. “How did you know?”

    “Well,” said the man, “you don’t know where you are — or where you are
    going. You’ve risen to where you are, due to a large quantity of hot
    air. You made a promise you have no idea how to keep, and you expect me
    to solve your problem. You’re in exactly the same position you were in
    before we met, but somehow, now it’s my fault ! “

  24. tselle says:

    We won WW II in less time than Obama has had to start his obamacare!!

  25. tselle says:

    Do you mean … act like Stalin??

  26. Naja pallida says:

    Sounds to me like it is ripe for someone to create several thousand sockpuppets, signup with fake information, and then wait until those signups are spoken of as a success story and then point out what has actually happened.

  27. Naja pallida says:

    Not to mention, many people want to hear the “all clear” so that they can sign up without running into issues.

  28. Drew2u says:

    When I made an account on the website, after inputting all my information, my results did not go to a page of my options; where you guys said you had to input your driver’s license or something, in order to see the plans available to your state. My immediate results were, “You qualify for Medicaid! Your State DHS will contact you with details.”
    Since my state did not set up its own exchange nor did my governor accept medicaid, and my governor actually kicking people off of the state’s medicaid, I doubt I will be accepted for the program (see also MHP’s weekend piece about those in Texas that fall into my same scenario).
    I called up the ACA phone number and they told me to get ahold of my state’s DHS. I asked my state about it and they seemed perplexed that I’d want to pay private insurance (were I to also get subsidies, I could afford the ~$28/month the subsidies would give me). As it is, they said that the results for Medicaid acceptance in my state will be around the 18th of this month.

    I have about $10,000 worth of surgeries starting in January that i’d like to know if I’m going to be covered and for how much, so knowing if I can shop on the exchange (and be granted subsidies) if my automatic Medicaid qualification is denied by my state is sort of important for me.

  29. Except they don’t tell you what the plans actually are, I didn’t find it terribly helpful for that reason, I want to see the details.

  30. Hey how does that actually work – what did you have to do to find out if you’re accepted, do you apply somewhere or what? For Medicare I mean?

  31. ezpz says:

    Why didn’t they hire this (or any other) ‘top notch IT/website guy’ three and a half years ago, when the law was passed?

  32. BeccaM says:

    My take on the security issues? I think it’s a disaster waiting to happen. Exactly what shape that might take, I don’t know.

  33. ariesmatt says:

    Um, he hired a top notch IT/website guy 2-3 weeks ago to oversee the repair/redesign of FYI.

  34. ezpz says:

    Interesting (and typical of this admin) that the person who issued the warning memo “resigned” while those who ‘knew nothing’ still have their cushy jobs AND, of course, their cadillac insurance plans.

  35. Drew2u says:

    Plus the G.W. story’s veraciy.

  36. Houndentenor says:

    I put them under more scrutiny, yes. Is that one producer? Or a culture? CBS has been second only to Fox for harping on the Benghazi story. I’m not convinced that now that an ex-Fox exec is now running CBS news that they are much better.

  37. perljammer says:

    So, one producer screws up, and now you don’t believe anything reported by the network?

  38. Drew2u says:

    CBS also doesn’t fact-check their stories.

  39. Drew2u says:

    Firstly with the narrative: “Obamacare” includes the states, so what are the numbers coming from the states?
    Obamacare includes numbers of women who otherwise couldn’t afford their basic care for being a woman; what are those numbers?
    Obamacare includes young people under 26 who otherwise would be kicked off their parents’ health insurance; what are those numbers.
    Obamacare includes people covered by the states via expanded Medicaid; what are those numbers?
    Obamacare includes people who shop not via the website but directly with insurance companies that have altered their prices of whom would otherwise render services inaccessible by those prospectors.

    Considering I have to wait another week before I hear yes or no on if I’m accepted by my state via Medicaid via Obamacare, numbers shouldn’t mean much right now.

  40. chris10858 says:

    I think most people realize that they’ve to the middle of December to signup for January 1st. Most people are lazy. It will be like the April 15th with the IRS where hoardes of people try to get signed up around December 10-15th.

  41. Mighty says: try this site. Gives pricing info up front and tells you what your subsidy will likely be. Then it tells you how to enroll in the plan you chose by calling the insurance company directly

  42. perljammer says:


    I posted this link above, but I’m repeating it here because I’m interested in your take on it. I find it very disheartening, myself.

  43. perljammer says:

    Could be that low enrollment numbers are a blessing in disguise. CBS has a story about serious identity theft risks associated with security issues.

  44. usagi says:

    The Silicon Valley big donors break Republican or want the valley to secede from the US and become the Libertarian paradise of their late-night, caffeine-fueled dreams.

  45. BeccaM says:

    Hit the ‘go to the desktop version’ button at the top right corner of the screen.

  46. BeccaM says:

    My experiences as of this last week:

    – 30 Oct, Weds: I decided to give up on my forever “pending verification” and “verification under review” log-in ID and create a new one.

    – The process went smoothly this time, and I was able to create a fully ‘identity verified’ account on Kind of defeats the whole “you’ve exhausted your verification attempts” security measure, because it just means you can keep starting over until it works. However, one thing I did was to use an alternate email address; someone anecdotally mentioned they believed it wasn’t possible to register again using the same email. Doesn’t matter — I own several internet domains and can crank out as many aliased email addresses as I could possibly need. In this case, I just used one of my existing alternates.

    – As a consequence, I was finally able to complete the application process, receive a notice of confirmed eligibility, and browse the plans. Another thing I decided to do was to ignore the subsidy/tax credit portion and apply as if I’m going to pay the entire premium. (Business has been good lately, and I might not qualify for the subsidy/credit. On the other hand, supposedly I can file a ‘life change’ later on and get a reduction if necessary. So on to the enrollment phase.

    – For me, as a 50 year old female non-smoker living in NM, the premiums ranged from around $200 for a bronze plan, all the way to around $500 for platinum. I’ve got issues with Blue Cross’s business practices (including the obvious way the keep changing their local doing-business-as name to fool people into thinking it’s not them). So I focused on the other plans, and further decided that at my age and given the increasing likelihood of needing healthcare, I didn’t want an outrageous deductible or out-of-pocket maximum.

    – I don’t travel much anymore, so an HMO is acceptable — at least for this coming year anyway. (Nice thing about PPACA: If in the next year I decide the plan isn’t working for me, I can change it to something else for 2015.) I found a local hospital network insurance group that has a very good reputation in the area (Lovelace). Gold level plan. $750 deductible. 15% co-insurance. Out of pocket max is $4k/year. Primary doctor’s visits are $10, as are generic ‘scrips; specialist visits and name-brand ‘scrips are $25. In and out-of-network emergency room visits are always $250 (I figure that covers me on those rare occasions when I -do- travel). Premium: $371/month.

    – The site says I’m ‘enrolled’ and that I should contact the provider. Upon the advice of the live-chat person I spoke with on, they recommended I wait a couple days before contacting the provider, to make sure the data gets there. I personally decided I’d hang on a full 5 business days, just to be sure.

    – One complaint related to that last: It says to contact my new provider, but doesn’t provide the information to do so. I mean, it’s not that difficult for me to bounce myself on over to the Lovelace website, but really, they ought to be providing the phone numbers and site address in an obvious place (i.e., where it says “contact your provider”) on the site.

    TL;DR: I think I’ll have insurance shortly, a plan costs roughly what I’m paying now for my temporary high-risk pool PPACA interim insurance, but with vastly better benefits.

  47. nicho says:

    Am I the only one who assumes that the people who developed the Obamacare website are the same people who developed the Americablog iPad site? Very very hard to use and navigate. Still haven’t figured out how to see comments. Very frustrating site — and has reduced my visits here significantly, since I’m automatically shunted off to the non-functioning version.

  48. Jimmy says:

    Well, the first thing the president needs to do is get off the apology tour and put the full power of office into getting these issues fixed. How about he tap into all those Silicon Valley big donors and get some help. I’m so sick of the constant apologies, which only plays into the hands of the GOP crazies.

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