Five months since the launch of the Washington Healthplanfinder insurance exchange, officials say many of the website problems consumers experienced in the early weeks have been fully resolved. At the same time, they acknowledge there are still thorny issues they are working to fix.
At the top of the list are more than 15,000 insurance applications that are “stuck.”
About 5,000 to 6,000 of them have problems because the data entered by consumers isn’t matching up with state databases that track which benefits, including Medicaid, applicants are eligible to receive. An applicant, for example, may name a different head of household or street address than is contained in the state’s other eligibility databases.
An additional 5,000 or so applications have tax-filing related issues, and the remaining 5,000 require more information from the applicant.
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Ryan O’Keven, 31, a self-employed mortgage broker in Seattle, is one of those who is stuck. Despite having started his application in early October, he and his wife are still without insurance.
O’Keven has received a number of reasons, including that the eligibility system couldn’t confirm his or his wife’s citizenship.
“I never quite get the feeling from representatives I’ve spoken to that they really have a grasp of what the issues are, or maybe they’re just not being told,” O’Keven said.
For their part, exchange officials say they’re working on the problems.
“We have a team of folks who meet on a daily basis to unstick these applications,” Brad Finnegan, the exchange’s associate director of operations, told exchange board members at a meeting Thursday.
Asked by a board member what fixes are being pursued, Finnegan said the exchange information-technology staff is in discussions with the state Health Care Authority and Department of Social and Health Services about how to change data-matching rules. “We don’t think it’s a good solution to have all these applications require a manual touch,” he said.
While there are still challenges, things have improved steadily since the exchange’s October launch, said Curt Kwak, chief information officer of the Washington Health Benefit Exchange, which operates Healthplanfinder.
“We haven’t had a single outage that was not intended,” he said. “From a stability and operations point of view, it is rock solid.”
The number of enrollments shows the Washington exchange has been working better than those in many states. Indeed, as of Feb. 25, the exchange had enrolled more than 100,000 people in qualified health plans, not counting Medicaid. And even though the end-of-the-year rush of applicants has eased a bit, the exchange site, wahealthplanfinder.org, is getting 55,000 to 60,000 visits a day.
While the site has not crashed in weeks, users do still face problems.
One of the most serious occurs when users find themselves locked out of their accounts, leaving them unable to complete their applications.
This can happen for one of two reasons: a system error, or the user has made too many changes in application data.
With respect to the latter condition, Kwak says it was intentionally designed to work that way. “It was to protect customers from owing money at tax time if the application was being tweaked to qualify for more financial help than allowed under the law,” Kwak said.
He said the tech staff noticed consumers were using the site as a calculator, entering different scenarios and different data to see if they could maximize the tax credit they would receive.
Unfortunately, it seems that many users also have been locked out after making innocent input errors and are unable to correct them. Recognizing that, Kwak said, “We do have some releases coming up that we think should ease the application functionality and allow more changes more easily for users.”
As for “system errors,” Kwak says those have been progressively reduced since the site’s launch. Such errors may require recoding by programmers.
Kwak says the exchange has not kept records on the numbers of accounts that have problems.
If lockouts or system errors do occur, users are advised to contact the exchange call center. But, as Kwak acknowledges, the call center can be an additional source of consumer frustration.
“I understand that the call centers have been swamped and people can’t get through in a timely manner,” he said. “There is an all-out effort to make sure the consumers are notified and taken care of. But it’s just the sheer number and volume that we are continuing to have to deal with.”
In fact, according to the exchange as of Feb. 11, wait times at the call center after an initial menu selection is made were averaging 37 minutes.
The exchange also tracked 100 applications made on Feb. 14 and found that only five involved an error.
The exchange also has had some problems with its autopay system. After consumers set up their accounts to automatically make premium payments, the final step of activating the autopayment, in some cases, was not completed.
Affected consumers received no indication of this. As a result, an unknown number of them received bills in February for two months of premiums (February and March). The exchange advises any consumers who encountered this to return to their online account and complete the autopay activation.
Another source of confusion stems from having three different calculators on the website that deliver considerably different results.
If consumers click on “Find and Compare Health Plans” on the home page, they’ll see under the heading “Your Savings” a hyperlink labeled “See if you qualify.” That link leads to a calculator that asks for the names and ages of applicants, as well as income information. It then estimates the applicant’s tax credit and provides an estimated premium for a silver-level health plan.
Alternatively, clicking on the site’s large “Find Quality Coverage” button at the top of the same page allows the user to review specific plans, with their estimated tax credit and premiums displayed.
Finally, consumers go through similar calculations in the process of actually applying for the plan they select. The exchange has acknowledged that each calculator employs different plan data in making those estimates.
But it’s not just the estimated premiums that vary. A test of the three calculators, resulted in estimated tax credits (which help defray the cost of premiums) for a married couple of $913, $679 and $787. Those credits should be the same regardless of the plan chosen.
According to Kwak, the only calculations to rely upon are those in the actual application process. The other calculators, he said, “are just simple estimates.”
Kwak noted that many of the problems result from the very complex set of interactions the site must manage with back-end databases that are not apparent to the public.
“This is still a brand-new marketplace,” Kwak said. “So we’re still working through the startup issues that we expected. I can only ask for patience from consumers as we continue to work through these issues.”