Healthcare website improves, but wave of cancellations upsets policyholders

The October launch of the Affordable Care Act’s individual health insurance option was a mess, but it’s gotten better, say those who are helping people around Virginia apply for coverage.

Improvements to the healthcare.gov website, which were due to be completed by Nov. 30, also let people find out how the new insurance options will affect them. For some it’s a lot better, for others, it isn’t.

Robin Davis, an application counselor at New Horizons Healthcare in Roanoke, has been helping people trying to use the website for the past two months. She says applicants didn’t give up despite its early problems and that the flow of applicants remained steady. “They’re very understanding that there are going to be issues with something of this magnitude,” she says. “Most folks we talk to are willing to come back again and again.”

They needed to do so because the site didn’t work at all when it was launched on Oct. 1. “It was horrible. It took us almost three hours to get through our first application,” Davis says. By early November, the same task took her 40 minutes, she says. “So it’s getting better.”

Davis, who sees about five people a day, says most are older, lower income and currently without any health insurance. They’re generally pleased with the monthly premiums, and most qualify for tax credits available to low-income applicants, she says.

But because Virginia hasn’t decided if it will take part in the proposed expansion of Medicaid, some applicants fall into a gap. They’re too poor to qualify for tax credits under the health-care law but have too much income to qualify for Medicaid.

Jill Hanken is an attorney with the Virginia Poverty Law Center, which has about three dozen “navigators” around the state helping people use the insurance exchange. She says her group has been working around problems with the website by using paper applications or the federal call center. Besides the website’s technical problems, many people are struggling to understand the “very different insurance landscape…people still have a lot to learn about it,” Hanken says.

The Obama administration revealed in November that only 27,000 people, including 1,023 in Virginia, enrolled in health plans using the federal website during its first 33 days of operation. Another 79,000 enrolled on state-run exchanges.

In response to problems with the exchange, the deadline for applying for insurance without incurring a penalty has been eased back from mid-February to March 31.

In addition to the ACA’s website problems, many individual customers’ health-care policies have been canceled because they didn’t offer coverage required by the law. The Wall Street Journal reported that more than 4 million people in 28 states had received cancellation notices by

Nov. 14. No numbers were available on those affected in Virginia; insurers aren’t required to report how many policies are being canceled.

For those facing a cancellation, it’s a big deal, says Herndon-based insurance agent Jonathan Katz. “It’s very widespread” among people who buy individual policies, he says. About 20 percent of his firm’s 2,500 clients are at risk. They started calling in early November with worried questions. “I set a personal record, I got 74 calls in one day,” he says.

Replacing the coverage is a complex decision for people to make, he says. His clients generally aren’t eligible for the tax credits to subsidize their premiums under insurance purchased on the exchange, he says. About 518,000 people in Virginia are eligible for the tax credits that would offset premium costs. The annual income threshold to be eligible is $94,200 for a family of four, and most of his clients make more than that, he says.

Without the subsidies, the pricing for plans on and off the exchange can be significantly higher. “The bigger story to me is what products and pricing are available for next year for people who don’t qualify for subsidies,” he says. “People are very upset, generally speaking. Some are happy, but not many.”

Clients who benefit are those who qualify for tax credits or have a pre-existing health condition that was making insurance expensive. They’re getting less expensive plans on the exchange, he says. But most others are not getting tax credits, just higher premiums. “It’s a real struggle. If I tell somebody their premium went to $1,200 from $600, they don’t have that money,” he says.

Admitting that his administration had “fumbled” rollout of the health-care law, President Obama announced in mid-November that insurers can extend for one year policies that had been cancelled because they failed to meet the law’s coverage requirements. At press time, it was unclear how the president’s move would affect cancelled policies in Virginia. Anthem Blue Cross and Blue Shield, the state’s largest health insurer, has been offering customers the option to renew early for one-year policies that otherwise would be discontinued on Jan. 1, according to the Richmond Times-Dispatch.

Hanken says all the uncertainty should spur consumers to get started now. “Things are getting better,” she says. “People will need to do the work to realize they have better choices.”