Years of debate, planning, education and outreach have come down to this: On Tuesday, Washington state residents — and people across the country — can begin buying health insurance in exchanges created under Obamacare, or the Affordable Care Act.
Aimed at the uninsured and those who have individual health-insurance policies, the online exchanges are a key part of the health-care overhaul President Obama signed into law in March 2010. The law intends to get all Americans covered by private or public health insurance, while attempting to deal with rising health-care costs.
Exchange officials hope that at least 130,000 state residents will enroll in health plans through the exchange by the end of this year and that 280,000 people will enroll in 2014. People who get their insurance through their employers won’t have to bother with the exchange.
In this state, the Washington Healthplanfinder exchange website is to open for business at 7:30 a.m. Tuesday. State officials are looking forward to a relatively smooth start, though they expect there may be a few problems as residents use the website to compare and shop for health plans offered in the exchange and apply for financial assistance to pay premiums.
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“There will be bumps along the way,” said Richard Onizuka, CEO of the Washington Health Benefit Exchange, the public-private partnership responsible for operating the Healthplanfinder.
“There are some things that we know about,” Onizuka said. “There are a lot of things that we don’t know about. But we are ready to fix things as they come up.”
The bumps may not be as noticeable as in other states, where implementation of the Affordable Care Act has sometimes met hostility from state officials.
Nationally, moves by some congressional Republicans to tie defunding Obamacare to passage of a budget bill or to raising the debt ceiling have become something of a wild card in their impact on the exchanges.
The challenges in this state are much more muted. Among the problems state officials say may arise is that the website and the system that supports it may work more slowly than expected.
In addition to any bugs in the system that may slow down the process, consumers may find the online application process to buy one of 46 exchange plans takes more time than they expect.
Dr. Bob Crittenden, senior health policy adviser to Gov. Jay Inslee, says he expects some people will be “irritated slightly” by the length of time required to complete an application.
But Crittenden, who has been coordinating efforts among state agencies to get Healthplanfinder up and running, counsels patience.
“Filling out an application for insurance is a longer process than just buying a ticket to San Francisco on Orbitz,” he said.
Exchange officials say they aren’t sure how long it will take consumers, on average, to complete the application to create an account on the site. But during consumer testing, they found that less than half of participants were able to complete the application within two hours.
The launch of the exchange comes after the state and others worked with community groups and organizations to train about 600 people around the state to be “in-person assisters” or “navigators” who are certified to help consumers one-on-one to enroll in exchange health plans or in Medicaid, depending on their income levels.
In addition, approximately 2,000 brokers and agents have also undergone training to help consumers enroll in exchange plans.
They have a huge challenge in front of them.
About 1 million Washington residents, including about 200,000 in King County, are uninsured. That is about 16 percent of the state’s population.
State officials also expect that about 325,000 residents will enroll in Medicaid over the next several years. That includes about 250,000 residents who are newly eligible as a result of the state’s Medicaid expansion, another component of the Affordable Care Act.
The key to getting residents to enroll is the Healthplanfinder website.
The technology team that built the site, led by Curt Kwak, the benefit exchange chief information officer, has spent the last few days uploading information about brokers and in-person assisters into the system.
“They underwent training and testing,” said Kwak, “but we have to go through the process of getting their information in there.”
The team is also making last-minute refinements to language and layout on the existing pages.
What’s more, final touches are being applied to several pages that have not yet been uploaded to the site.
Most important, there will be pages that lead users through comparing health-care plans and getting specific pricing.
The comparison tools will allow consumers to search for plans that are accepted by a specific health-care provider or hospital, and to sort plans by premium ranges. And there will be a wizard available that consumers can use to narrow their search by answering a series of questions.
The benefit exchange is also planning an online chat feature and support for mobile users in a future release.
“We’d like for customers to be able to access customer support through this service on Washington Healthplanfinder,” says Kwak. “We also want to build out our mobile experience, which would ease access, data look up, and status checking for mobile users.”
While Kwak doesn’t expect everything to go without any hiccups, he said he expects a relatively smooth rollout.
“We feel prepared to take large volumes of consumers on the site,” he said. “However, we have processes in place to address any issues that may arise.”
Specifically, for the first 45 days, the benefit exchange will man a command center with staff from IT, communications and operations, who will be ready to respond quickly to any glitches.
In addition to the website, the benefit exchange is maintaining a call center in Spokane, which opened in early September.
It has 80 trained staffers and 60 more who can be called on for high-volume times.
While the state mobilizes for heavy volume Tuesday, officials don’t expect a lot of people to complete their enrollment right away.
They predict most people are going to spend some time comparing health plans before they make a decision, especially because coverage will not start until Jan. 1.
State Insurance Commissioner Mike Kreidler is encouraging consumers to “shop around” and compare health plans sold inside the exchange, as well as those plans sold outside of the exchange, before they decide which health plan is right for them.