ObamacareBy Ann McCreary and Marcy Stamper

In-person assisters at Room One, trained to help people enroll in health insurance under the federal Affordable Care Act (ACA), saw their first uninsured client – a man in his late 50s – sign up for coverage on Friday (Oct. 4).

“It was the first time he’d had insurance in his life. He was jubilant,” said Erin Flahive, one of two Room One staffers trained to help people navigate the new health insurance system.

“It was a really satisfying experience,” said Elana Mainer, executive director at Room One, a Twisp-based nonprofit social services agency. “I got to see the joy” as the man left the office.

The state’s online Health Benefit Exchange, where people can evaluate different insurance plans and purchase coverage, officially opened Oct. 1, but was mired in website glitches that made it inoperative on and off for about two days. A damaged fiber-optic line Thursday eliminated Internet access in much of the Methow Valley for a day.

“For a few days we basically couldn’t help people, because we help them through the website,” Flahive said.

By Friday (Oct. 4), however, the “Healthplanfinder” website was functioning and Flahive and Lori Valentine, another in-person assister, were able to help people work through the new process.

Many people across the state went straight to the Health Plan Finder website. When the site launched at 7:30 a.m. Oct. 1, it attracted a deluge of hits, making it slow to load and meaning that people were not always successful signing up for insurance, according to Bethany Frey, communications specialist for the Washington Health Benefit Exchange.

But by the start of its second week and numerous technical fixes, 9,452 people had enrolled through the site and more than 10,000 more had submitted applications (both for health plans on the Exchange and for Washington Apple Health, the state’s Medicaid program, which has been expanded to cover people earning higher incomes under the ACA).

The website was slow because people were interacting with the system in “unexpected” ways, exploring the site and clicking on different areas to see how it works, said Frey. “It wasn’t a volume issue – we were required to do extensive testing – but there was unexpected user behavior,” she said.

While the average wait time through the Exchange’s call center was reported as 14 minutes during the first few days, delays increased as individuals who were unable to complete applications online instead used the telephone service, according to Frey.

Friday afternoon, after a recording about a “higher-than-normal call volume,” the wait was predicted to be 73 minutes. On Monday morning (Oct. 7), the system disconnected callers a few times before estimating a wait time of 62 minutes, and waits on Tuesday also exceeded an hour. Callers do not have to remain on hold, but can leave a phone number to receive a call-back once a representative is available.

In the Methow Valley, people can also get detailed information from Flahive and Valentine, who have completed 30 hours of training to qualify as in-person assisters (called “navigators” in some states). They are trained to help people understand the new health-insurance system and how to enroll on the state’s website.

Since enrollment opened, Room One has been receiving about five calls a day with questions about signing up for health care, and several people have stopped by the office, Mainer said. Room One is scheduling appointments to work with people on insurance enrollment on Thursdays and Fridays.

Flahive said help provided by Room One’s in-person assisters is geared to the needs of each person.

“They don’t have to share their social security number or personal information with us. We work with whatever their comfort level is. Some want to fill out the application together; others want to turn the screen away and do it themselves,” Flahive said.

Because the enrollment period continues through March 31, 2014, Room One staff is advising people not to rush to sign up. The process can be done in stages, by opening an account online, determining eligibility for subsidies or tax credits, and evaluating plans and costs before actually purchasing insurance.

“We encourage people to wait and think about it,” Flahive said.

Because the primary goal is to insure uninsured or underinsured people, Flahive said, some of the assistance is geared to helping people understand basic aspects of health insurance, such as premiums or copays.

Flahive said she and Valentine are encountering questions that they are unable to answer. “What people want to know is not only the costs … but what benefits are going to be covered,” Flahive said. “Are they going to be able to continue seeing their mental health provider? Can they see a specialist in Seattle?”

To find answers, Flahive said she and Valentine turn to the lead agency that oversees the network of in-person assisters in this region, Community Choice in Wenatchee.

While in-person assisters are able to provide information, they are prohibited by the Affordable Care Act from offering personal advice. “But we still want to act as advocates for people,” said Mainer. “Instead of telling them which health insurance option is right for them, we help them identify strategies that are relevant to them [by] walking them through the process … and helping them identify their own questions and answers.”

Mainer said Room One also plans to provide information and assistance to local small businesses and nonprofit organizations. A discussion forum that will include representatives of Community Choice is planned for Nov. 5.


Insurance companies in Okanogan County on the Exchange

Community Health Plan of Washington • LifeWise Health Plan • Premera Blue Cross


Main contact numbers

Washington Health Plan Finder

Room One
help with the Exchange, Medicaid and Medicare:

Statewide Health Insurance Benefit Advisors
(Twisp-based volunteer): (307) 399-9482

Washington Customer Support Center
questions about health coverage options, how to access financial help and what you need to know about the enrollment process:
855-WAFINDER (855-923-4633);
TTY/TTD 855-627-9604
7:30 a.m. to 8 p.m., Monday through Friday



Important dates for health insurance

People have until March 31, 2014, to sign up for health insurance through the Health Benefit Exchange during this initial extended open-enrollment period. Coverage will start Jan. 1, 2014, for anyone who signs up by Dec. 23.

After that, the cut-off date for each month is the 23rd for a policy to become active the first of the following month. Anyone who signs up after the 23rd will have to wait for the first of the month after that – at least five weeks. For example, anyone signing up between Dec. 24 and Jan. 23 can expect coverage to start Feb. 1, but if a person signs up on Jan. 24, coverage will not start until March 1.

After March 31, the next open-enrollment period runs from Oct. 15 through Dec. 7, 2014. People can still buy insurance on the individual market (with no subsidies available) between March and October.


Health insurance privacy tips 

Unscrupulous individuals have been taking advantage of the newness and confusion surrounding health reform to try to get access to people’s personal information, according to a warning from the state’s Health Benefit Exchange.

No one connected with the Exchange will call or approach someone to ask for personal information, they said. While there may be community outreach to help familiarize people with options or let them know they can sign up for health coverage, these people will not ask for identifying information. This information is only required when completing the sign-up process to purchase an insurance policy.

Despite some concerns that navigators will have access to personal information, they are all required to go through a thorough background check, according to Bethany Frey, communications specialist for the Washington Health Benefit Exchange. No one will have access to this information or the website without appropriate training, she said.

People can call the Health Plan Finder support center at 855-WAFINDER (855-923-4633) to verify that someone has been certified to assist people through the Exchange. They can also report scams or fraud through that number.