Health & Medicine

California health exchange reports improvements, more than 16,000 household sign-ups

The head of California’s health insurance marketplace said Tuesday that more than 16,000 households have completed applications in the first five days of enrollment, largely overcoming early technical setbacks that continue to hamper other states.

Covered California Executive Director Peter V. Lee said the response from Oct. 1 through Oct. 5 underscores the demand for health insurance in the state. The federal health care law requires nearly everyone to purchase insurance or pay a penalty. Covered California estimates that over the first six months between roughly 500,000 and 700,000 customers who are eligible for a subsidy will enroll in the marketplace.

Californians appear to be having a smoother experience with the new health care law than their counterparts across the country.

In Washington, federal officials have admitted the need to repair design and software issues that have slowed service for more than 30 states. The Obama administration has yet to provide application or enrollment figures for, and is unlikely to until sometime next month.

Even some of the states running their own exchanges have had their share of technical problems. Maryland, a state that received more than 174,000 unique visitors to its exchange website through Sunday, reported enrolling just 326 customers and 13,532 accounts created with verified identities.

“We have added server capacity, made technical adjustments, and improved call center employees’ ability to serve consumers,” the Maryland exchange said in a written statement. “The steps taken so far have improved performance, and we expect the user experience will advance substantially in the days and weeks ahead.”

California officials determined that 28,699 people in the 16,311 households that have applied are eligible for coverage. Another 27,305 households have partially completed their applications, Lee said. In addition, 430 small businesses registered with the state agency.

“Looking back at this one week, the response has been nothing short of phenomenal,” he said.

It’s unclear how many of the potential customers will buy insurance through the exchange or qualify for Medi-Cal. Actual enrollment figures will not become available until customers start paying for and then receiving health insurance on Jan. 1.

At the agency’s headquarters in Sacramento, Lee said he hadn’t planned to release a progress report so early but decided to do so to counter persistent criticism of the agency’s activity. He singled out a blog post on a conservative website concluding that nobody here has enrolled in the state exchange.

“We thought it’s really important to let the media know the facts,” Lee told The Sacramento Bee, adding that he personally reads the commentary.

In describing some media coverage as “continued efforts at disinformation,” Lee acknowledged that the agency has had some early challenges with its $313million online enrollment platform.

“Has it been perfect?” he asked about the rollout of “Absolutely not.”

“Has it been, and is it, pretty darn good? Absolutely yes.”

Despite getting off to the rocky start, Covered California has racked up 987,440 unique visitors to its website and more than 59,000 calls into its customer service center through Saturday. Phone wait times have improved from reported highs of 40 minutes on Tuesday, the day of the launch. The average wait time for the five-day period was more than 15 minutes, but Lee said the waits got shorter and came in at an average of less than four minutes by Friday. The target is for eight in 10 calls to wait 30 seconds or fewer.

Californians have until Dec. 15 to sign up for coverage that begins Jan. 1. The first open-enrollment period runs through the end of March.

Glenn Melnick, a health care economist at the University of Southern California, said he isn’t surprised by any of the early figures emerging from the exchanges.

“It’s a herculean effort, what they are trying to do,” Melnick said.

He said it’s expected to see people grasping for any available metric to begin to quantify the outcome of such a massive undertaking. “It’s like a football game,” he said. “You focus on the things you can keep score on.”

Melnick believes a bigger challenge for the state will be reaching out to and enrolling younger, healthier people after an initial wave of higher-risk and higher-cost customers join the exchange. California’s outreach includes an $80million television and radio ad campaign and more than $40million for nonprofit clinics, union groups and schools to embed in communities and educate their members.

“At the end of the day less than half of the people who sign up for this will sign up on the Internet,” Melnick said.

“The rest of these folks will do it in person.”

Some 37,000 people nationwide have completed applications for coverage, according to Kaiser Health News, which received the figures from eight state exchanges. Marketplaces in Oregon, Minnesota and Colorado told the agency they would wait until the end of the month to begin releasing application figures.

California plans to continue reporting weekly on the numbers of visits to its website and the number of consumer calls to its service centers.

Experts believe that among the ways to lure people to the online platform – which proponents of the law strive to make as easy as shopping for travel prices – is to provide more information upfront. To that end, Covered California this week launched a new provider directory that allows customers to see whether their current doctors or hospitals are in a new plan.

Molly Weedn, a spokeswoman for the California Medical Association, said the group was generally glad to see that a list of providers is now available, although it’s fairly cumbersome to access the list. She said the association has put together its own set of instructions.

The association also found a few early mix-ups on the website, such as listing OB/GYNs as ophthalmologists and listing some physicians as speaking languages that the group knows they don’t speak.

Still, Lee hailed the release of directory as significant. “This is one week in to making history,” he said.

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