The exchange website has mixed results. Photo by Marcy Stamper

The exchange website has mixed results. Photo by Marcy Stamper

By Marcy Stamper and Ann McCreary

Despite being stymied by computer error codes and troubling erroneous information like the system’s assertion that a family member was ineligible due to incarceration, a sampling of persistent Methow Valley residents who signed up for health insurance through the state’s exchange were pleased with the expanded coverage and lower costs.

Eager to get improved coverage for health care and to escape a $7,500 deductible, one Methow Valley resident logged onto Washington’s Healthplanfinder website on opening day, but found the interface “clunky and difficult, as if all circuits were busy.”

“It booted us out because we answered one question incorrectly,” he said. It took more than a week to get an explanation, but unchecking a single box immediately resolved the problem.

Another local family thought they were being prudent to allow the initial rush to subside and waited until the third week of October. “I found it quite useful, shopped, saw what was available and started my application. The website was so clear — I got to the end to submit my application within half an hour,” said the woman.

But clicking “submit” did not lead to a speedy completion of the transaction, which, six weeks later, has yet to be finalized. She repeatedly got an error code that instructed her to call the state office, but she could never get through.

She finally left a message and received a return call from an assistant who explained that they were among many already in Washington’s system whose information became scrambled, tagging them as non-citizens or incarcerated, for example.

“We are seeing instances in which people who have previously had any kind of state assistance [food stamps, Medicaid, etc.] may have issues signing up,” said Bethany Frey, communications specialist for the Washington Health Benefit Exchange, by email. “This is because if anything is entered differently on their application, such as their name, it will create an error when we ping the state eligibility system.”

The woman who got the error code finally resorted to a paper application and hopes to receive confirmation of coverage by the end of the month.

Those who spoke to the Methow Valley News about their experiences asked not to be identified because of the personal health and income information involved.


Help sorting through options

Not everyone is trying to navigate the website on his or her own. Since the exchange launched in October, specially trained navigators at Room One in Twisp have provided assistance to more than 60 Methow Valley residents.

In November, 31 people received in-person assistance at Room One, and 18 successfully signed up for insurance, said Lori Valentine, a client services specialist there. Since enrollment opened in October, Room One has received an average of 10 phone calls a day — or about 200 a month — from people with questions about signing up for insurance online.

“In general, it’s been going pretty well,” Valentine said this week. Many people, however, have been stymied in the enrollment process by a website that is down for days at a time, or by issues particular to their own situation.

“We’ve definitely had to meet with some people multiple times,” said Valentine. “It’s not straightforward at all for some people. For other people, there are just no errors.”

Although they are trained and designated as navigators, Valentine and colleague Erin Flahive have to call the same phone number for help if they encounter problems on the website or get questions they can’t answer. They have the same problems as their clients in getting through to someone on the help line.

“That’s the most frustrating part — they cannot get through to the call center, and neither can we,” Valentine said.

Valentine takes a philosophical view of the problems accessing both the website and the consumer call center. “I went into it knowing it was going to be glitchy, so I’m not taken aback when it’s bumpy,” she said. “They’re understaffed. They’re training [additional people] as fast as they can.”

Frey said they have stepped up their efforts to handle the number of applications. “Healthplanfinder is steadfast in our commitment to address the issues that some users are currently experiencing to get them through by Dec. 23 [the deadline for coverage to start Jan. 1]. That’s why we are nearly doubling our call center staff and are performing regular maintenance to address site issues,” Frey said.


Behind the scenes

Beneath the dysfunction encountered by users of the website, there is another layer visible to the technical staff at the exchange, who are able to track an applicant’s efforts to sign up. One woman received a letter about 10 days after her first attempt to buy insurance, saying, basically, “We see you’ve started an application but didn’t complete it — what’s wrong?” It urged her to return to the website to finish up, but the online portal itself was the source of the bottleneck.

Another applicant whose family had been receiving insurance through the state’s subsidized Basic Health program was delighted to find that they are now eligible for the expansion of Medicaid, which will cover people who earn up to 138 percent of the federal poverty level. Under the expansion, a family of four making less than $32,500 can qualify for free health coverage.

“It will be a great program,” said the woman. “We’ll get dental and eyesight, and the kids will be covered through age 26.”

Although the website allows people to compare numerous insurance plans, one “shopper” said there is really no way to compare apples to apples because the Affordable Care Act requires that policies cover so much more than in the past. “Now we get unlimited doctors’ visits, preventive health care, maternity coverage — all with no lifetime maximum,” said a Twisp man who has already paid for the new policy for himself and his wife.

“I have a large family with a lot of health problems — my dad was always afraid to go to the doctor because he thought it would cost a lot of money — it made the rest of us crazy,” said another local man who had bought insurance through the exchange. “I’m really happy — it makes a big difference to us in the way I think about health care.”

Valentine said several of the people who have signed up with help from Room One navigators are insured for the first time in their lives.

“It’s a beautiful thing. A lot haven’t gone to the doctor in 40 years. They tell me, ‘I can’t wait to see a doctor.’ They’re worried about something and have probably been worried for a decade,” said Valentine.


State stats

Although the exchange website has been problematic — and has been shut down for maintenance and upgrades for most of the past week — more than 18,000 Washingtonians have enrolled and paid, another 43,000 have completed their applications but not yet paid, and 54,000 are in the application process, according to an update from Washington Healthplanfinder.

Even more — almost 160,000 — have been covered through the expansion of Medicaid. In fact, more than 66,000 of them received immediate coverage through Apple Health.

The website has attracted a lot of interest — 790,000 individuals have looked at it, more than half during the first month — and about one-fourth created an account, which is the first step in purchasing a policy, according to a detailed status report for October. Detailed November tallies have not been released yet.

While there has been significant concern nationwide about encouraging younger, healthier people to sign up for insurance — part of the financial calculation to make the system work — in Washington, the highest enrollments have been among young people. The largest group were those under 18, due to the expansion of Medicaid, which has added 13,000 more children, but individuals between 26 and 34 were the next-largest group to sign up, accounting for more than 11,000 new enrollees. Another 6,000 between 18 and 25 also signed up for coverage.

Washington’s call center has been busy, fielding almost 70,000 calls in November alone. Wait times have averaged 23 minutes, about a third of the delay in early October.

With the Dec. 23 deadline approaching, call center staff are concentrating on helping people who have received error messages when trying to sign up through the website. Others have been encouraged to find an in-person assister in their region through the website.

In an announcement about the website problems on Friday (Dec. 6), the Health Benefit Exchange said that customers had experienced “intermittent slowness and even brief outages.”

“While the site has not been available to the public, the maintenance environment has provided us the opportunity to process thousands of paper applications and those previously affected by error codes,” said the exchange’s CEO in the announcement.


Health insurance help

Deadlines: The deadline to enroll for coverage to start on Jan. 1 is Dec. 23. People can still apply through March 23, and would get coverage the first of the following month.

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.

Exchange website:

Call center: 855-923-4633, Monday through Friday, 7:30 a.m. to 8 p.m.

In-person assisters at Room One: 997-2050. They have been scheduling appointments with people on Thursdays and Fridays from 10 a.m. to 3 p.m. The navigators are completely booked with appointments until Dec. 20, and have expanded their schedule to include appointments next Monday and Tuesday, Dec. 16 and 17.

Paper applications: Available on the website.