Rosilyn Wells, a navigator in Lawrence for the Affordable Care Act, didn't have much luck getting into the new health insurance marketplace after it went online Tuesday. So she put off all her appointments with people wanting to enroll for this week. She's crossing her fingers the site will work by then.
"None of the navigators (in Kansas) have yet been able to enroll anyone," she said Friday. "The website is still bogged down. I don't think they expected the capacity they're getting."
An overload of visitors to healthcare.gov in the first few days after the rollout of the marketplace has slowed down the application process for many Americans. Millions of people have reportedly attempted to access the site, which has been plagued by glitches. It's not clear how many people have succeeded in signing up for the new insurance plans. The site's operations were suspended over the weekend so officials could try to fix the problems, though call centers remained open. Healthcare.gov was expected to go back online Monday.
Officials tasked with implementing the 2010 health care law in Kansas, cautioned residents to be patient, because plans bought now don't go into effect until Jan. 1.
Despite the delays, some people in Kansas have been able to enroll in insurance on the marketplace, though no official numbers are available. Blue Cross Blue Shield of Kansas, one of the insurers offering plans on the exchange, confirmed that it has received electronic transactions from Kansans who had apparently picked plans from the insurer, according to company spokesperson Mary Beth Chambers.
"We do know that people have been getting through," said Linda Sheppard, director of health policy and analysis for the Kansas Insurance Department, adding: "But we have been encouraging Kansans to just wait, give it two or three weeks. The coverage does not become effective until Jan. 1 as long as they enroll by Dec. 15."
She also pointed out that since the state declined to set up its own marketplace, leaving it up to the federal government to operate it, Kansans are trying to sign up for insurance on the site at the same time as residents of the other 33 states that also refused to operate their own exchanges.
Sheldon Weisgrau, director of the Health Reform Resource Project in Kansas, isn't surprised there have been technical problems with the online marketplace. He has been warning for weeks that there would probably be glitches during the initial rollout of the site, which he has called a "giant IT project." In some aspects, he said, the delays are a good sign.
"I think the interest and the volume of people trying to get in and get information has exceeded everybody's expectations," Weisgrau said. "Whether that has been because outreach has been better than expected or people are more tuned in than we realize, I don't know. I wouldn't be surprised if the opponents making noise about this hasn't generated interest in it. It's like when people ban a book and it increases sales."
He added that he has "no doubt" a marketplace run by the state of Kansas would have had a smoother rollout. Kansas was one of six states that in early 2011 received a so-called early innovator grant to set up its own exchange. Sandy Praeger, commissioner of the Kansas Insurance Department, started working with more than 300 stakeholders across the state to design the marketplace. That effort was cut short when, in August of that year, Gov. Sam Brownback sent the $31.5 million grant back to the federal government.
Amanda Kong, an AmeriCorps member at the Lawrence-Douglas County Health Department who has been trained as a navigator for the marketplace, said she hasn't yet been able to sign anyone up for insurance because of problems with healthcare.gov. She did hand out one paper application, she said.
Kong has mostly been fielding Affordable Care Act-related questions from the public, such as whether people can turn down insurance through their employers and buy it on the marketplace (answer: They can, but they won't be eligible for tax credits unless their employer's offer represents more than 9.5 percent of their income.) She has even talked to parents asking insurance-related questions on behalf of their adult children (under the law, Americans can remain on their parents' insurance until the age of 26).
She also spoke to someone who makes too much money to qualify for Medicaid in Kansas — which declined to participate in the law's expansion of the program — and too little to qualify for tax credits on the marketplace. Kong had to refer the woman to Lawrence's two safety-net clinics, Heartland Community Health Center and Health Care Access.
In her first week as a navigator, Kong often has had to refer to her instruction materials to answer questions about the 960-page law.
"I have a giant manual," Kong said, though she understands why she needs it. "Our country's never done anything like this before."