NYT: Uninsured Find More Success via Health Exchanges Run by States

[Scuba]

So, is it a) lousy technology, b) high demand, or c) sabotage of the federal sites?


http://www.nytimes.com/2013/10/09/us/politics/uninsured-find-more-success-via-health-exchanges-run-by-states.html?_r=0

WASHINGTON — Robyn J. Skrebes of Minneapolis said she was able to sign up for health insurance in about two hours on Monday using the Web site of the state-run insurance exchange in Minnesota, known as MNsure. Ms. Skrebes, who is 32 and uninsured, said she had selected a policy costing $179 a month, before tax credit subsidies, and also had obtained Medicaid coverage for her 2-year-old daughter, Emma.

“I am thrilled,” Ms. Skrebes said, referring to her policy. “It’s affordable, good coverage. And the Web site of the Minnesota exchange was pretty simple to use, pretty straightforward. The language was really clear.”

The experience described by Ms. Skrebes is in stark contrast to reports of widespread technical problems that have hampered enrollment in the online health insurance marketplace run by the federal government since it opened on Oct. 1. While many people have been frustrated in their efforts to obtain coverage through the federal exchange, which is used by more than 30 states, consumers have had more success signing up for health insurance through many of the state-run exchanges, federal and state officials and outside experts say.

...

Daniel N. Mendelson, the chief executive of Avalere Health, a research and consulting company, said: “On balance, the state exchanges are doing better than the federal exchange. The federal exchange has, for all practical purposes, been impenetrable. Systems problems are preventing any sort of meaningful engagement.”

[Mass]

1. It may be all three.

They clearly have been overwhelmed, but, at the same time, it is easy to organize a denial of services, if you know how to procede.

[Yo_Mama]

4. I don't think it is being sabotaged

I think the "sabotage" is people trying over and over again, because they cannot get through.

Sabotage would not account for the problems with generating the accounts.

Because of the logjam I am now staying off, because I realize that the people trying to pick between employer and self insurance have a very short deadline. But what I hear is that they still can't get through.

The worst mistake I see with this system is that they underestimated capacity needs for some astonishing reason, and that they failed to allow looking at the plan info before the application process, which would have lightened the load incredibly during the initial period.

And I am in the IT industry and have been for a long time, so I know of what I speak, and this is a true fuckup that cannot be blamed upon the "enemy". However, because that's true, it should be fixable, but I am not sure if it can be fixed in the time frame.

I find the fundamental design flaws in this system simply inexplicable, and they cannot be blamed on outside nefarious services. Whoever wrote the specifications is to blame. The design of the system is more than half the problem - informational inquiries are dependent on creating an account and identity verification, and this alone creates massive additional and unnecessary overhead.

If you know or can find out which insurance companies are participating in the exchange in your state, you can simply shop at their websites, and most of them also have subsidy calculators.

[ProSense]

2. It's likely due to two things.

The state-run exchange in New York announced Tuesday that it had signed up more than 40,000 people who applied for insurance and were found eligible.

“This fast pace of sign-ups shows that New York State’s exchange is working smoothly with an overwhelming response from New Yorkers eager to get access to low-cost health insurance,” said Donna Frescatore, the executive director of the state exchange.

In Washington State, the state-run exchange had a rocky start on Oct. 1, but managed to turn things around quickly by adjusting certain parameters on its Web site to alleviate bottlenecks. By Monday, more than 9,400 people had signed up for coverage. The Washington Health Benefit Exchange does not require users to create an account before browsing plans.

...the states that are running their own exchanges likely have less uninsured than than the states that are not. Sure by population, states like California and New York even with a smaller percentage of their populations uninsured means more people than most states. Still, the federal exchange is catering to states like Florida and Texas, which has the most uninsured in the country.

[Ohio Joe]

3. I don't get it...

The article seems to imply you can sign up on either site if you live in a state that has a state run site. The fed site asks for your state right off and directs you to the state site if you live in a state that has one... You don't have much choice but to go to the state run site if one exists so... I don't much get it.

[PoliticAverse]

6. Yes, if the state is running the exchange healthcare.gov just redirects you to it

once you specify your state.

[PoliticAverse]

5. NY's exchange did have some issues as they reportedly received over 2 million hits the first 2 hours

the exchange opened.

See: http://www.cnybj.com/News/Articles/TabId/102/ArticleId/37767/language/en-US/ny-state-of-health-site-gets-over-2-million-hits-in-first-two-hours-to-begin-open-enrollment-period.aspx