Despite four days of computer glitches in the federal health insurance marketplace for the Affordable Care Act, Nebraska was right not to set up its own state system, Nebraska Insurance Director Bruce Ramge said Friday.
He said that's true even though he hadn't heard of a single Nebraskan successfully enrolling in a health plan through the federal website, healthcare.gov, which went online Tuesday.
Nor has the Iowa Insurance Division gotten word of an enrollment, said spokesman Tom Alger.
CoOportunity Health of Des Moines, an insurer offering policies on the marketplace, also has not received a report yet of enrollments in Nebraska or Iowa, spokeswoman Leigh McGivern said.
But Blue Cross Blue Shield of Nebraska got its first Nebraska application from the marketplace, spokesman Andy Williams said Friday, from a current Blue Cross customer who was renewing an individual policy under the federal law, also known as Obamacare.
“We're kind of trying to sit back and be patient, to see how the glitches are ironed out,” Ramge said. “I'm assuming they will. We're trying to tell people to be patient and calm. They've got until Dec. 15 to get coverage that begins Jan. 1, and open enrollment goes through March 31.”
The federal website was still balky for most people Friday, but there was no guarantee a state system would have been better, Ramge said. Nebraska had received only one proposal from a computer programming vendor to set up a system for a state marketplace.
“We'd be here dealing with a rough start as well, had we gone with a state-based system,” he said.
J.P. Sabby, a health policy analyst with the department, said some state sites worked better than others. California's site seemed to work but had delays of up to three hours, and Oregon's website opened only for insurance brokers.
In Minnesota, a state employee accidentally emailed 2,400 insurance agents' Social Security numbers to a brokerage, according to the Minneapolis Star-Tribune.
“All of the states had issues during Day 1,” Sabby said. “There were a lot of people trying to look at the plan rates, so it was very slow.”
An estimated 15 percent of Nebraskans and Iowans could buy individual insurance on the marketplaces. Those with insurance from employers or who are on government plans such as Medicare and Medicaid are not eligible to use the marketplaces.
The Center for Medicare and Medicaid Services, which oversees the insurance law, doesn't have figures on successful enrollments through the website available, said Nanette Foster Reilly, administrator of the Kansas City, Mo., regional office, which covers Nebraska, Iowa, Kansas and Missouri.
On Wednesday and Thursday, 7 million Americans visited healthcare.gov, she said Friday.
“That's more than the number that visits Southwest Airlines in a month,” she said. “The volume is really showing you that there's a great deal of interest in the marketplace.”
People who need individual insurance should “be patient, but definitely go online and explore your options. Create an account, and apply and select a plan.
“Being able to compare all the plan choices in one place, being able to compare them on an apples-to-apples basis is new and unique and what makes the marketplace exciting.”
She said she didn't have figures on how many people have qualified for tax credits or other subsidies, but “there are consumers who are applying and enrolling” with the subsidies.
Alger, from the Iowa Insurance Division, said the state marketplaces have had “mixed results,” with some enrolling people and some not.
“Are the early problems an indicator of a flawed design in the system?” Alger said. “It's clear we have big pressure on the system right now, but we really don't have any expectation that it's going to continue to be that kind of a problem over time.
“There's a lot of pent-up interest in this. Most of these things that are problems now seem to be related to overload. When that settles down, we expect problems to start to resolve themselves.”
Ramge said the 3,200 Nebraskans who are covered by the state's high-risk health insurance pool will be able to enroll in health care plans for coverage to start Jan. 1, and every member of that pool can save money by buying plans through the marketplace. One of the provisions of the federal law is that coverage can't be denied because of someone's health condition or previous health insurance rejections. Rates in the pool are 50 percent higher than average in Nebraska.
Ramge's department added one employee, a consumer affairs person, to take healthrelated calls, which “seems to have been just right.” Some people have called about the marketplace because they didn't understand that the state office doesn't run it.
Ramge said he hasn't tried to open the federal website because he doesn't want to be a “rubbernecker. I don't want to add to the problems, just one more person logging on.”
As a test, he said, one department staff member has been trying to sign on but has been unsuccessful.