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Health care sign-ups pick up pace in November


Published:   |   Updated: December 11, 2013 at 02:45 PM

More Floridians are signing up for the new federal health insurance program than residents in any other state relying on the federal exchange, with nearly 18,000 registering over the last two months, according to figures released Wednesday.

Nearly 14,500 Floridians signed up under the Affordable Care Act in November. That compares to about 11,000 in Texas – another populous state that’s using the federal government’s website, according to enrollment statistics from the Health and Human Services Department

Florida’s November enrollment figures are considerably higher than the dismal 3,500 in October when sign-ups were hampered by technical glitches with healthcare.gov. But it’s still far less than what officials had originally projected for Florida and nationwide.

Wednesday’s enrollment statistics showed that 364,682 people nationwide have signed up for private coverage as of Nov. 30. That figure is less than one-third of the 1.2 million people officials had originally projected would enroll nationwide by the end of November. Federal health officials said during a conference call with the media Tuesday night that they expect the numbers to grow in the coming months, with a likely surge close to the March enrollment deadline.

The Obama administration projected 7 million consumers would sign up for coverage during the first year, including about 477,000 in Florida.

Experts have been working around the clock to fix the troubled website, and federal health officials have said the site is now working for the vast majority of users.

Jodi Ray, who oversees the navigators for the University of South Florida in Tampa, recently sat down with a family and completed one application through the website and another for the children’s Medicaid program in less than an hour.

“It worked that fast. It was that easy,” she said.

Since the site launched at the beginning of October, 281,517 Floridians have taken the first step in applying for coverage and 75,480 are eligible for a subsidy to help pay for it, according to federal health officials. But the enrollment data was not broken down into detailed demographic information. Ray said Florida applicants don’t fit a particular profile, so far.

“They’re not necessarily the sickly. They’re not necessarily the poor. They’re not necessarily the white or Hispanic. They are a whole range of demographics,” she said.

The Obama administration and insurers are working desperately to target healthy, young adults as they need them to enroll in the marketplace to offset the costs of paying for older, sicker consumers.

The federal health law is facing several hurdles in the wake of the botched website rollout. The administration must find a way to lure frustrated consumers back to the improved website, which now includes a reset button so consumers can start their bungled applications from scratch. Federal health officials are also giving priority to those who visited the site in the past two months, but couldn’t complete their application because of technical problems. Many consumers are receiving an email inviting them back to the site and the response has been strong, said Julie Bataille, communications director for the Centers for Medicare and Medicaid Services.

But many navigators fear it will be difficult to complete the enrollment process before the Dec. 23 deadline, allowing consumers to start getting health coverage in January.

Navigator Allie Stern sat alone in her South Florida office last week waiting on a no-show appointment. Most counselors were unable to enroll consumers on the spot in October and November because of the website glitches and instead scheduled follow-up appointments for when the site was functioning more smoothly.

“People make appointments and they don’t show up,” she said.

Officials must also fix crucial back-end problems causing a massive backlog of applications that insurance agents and brokers can’t process because of problems with the federal website, including incomplete enrollment files sent electronically to insurance companies.

Just Tuesday there was an extended maintenance outage. And some states running their own websites are also having problems.

Health and Human Services Secretary Kathleen Sebelius said in a blog post early Wednesday that she is asking the department’s inspector general to investigate the contracting process, management, performance and payment issues that may have contributed to the flawed launch of HealthCare.gov.

The 14 states running their own websites enrolled 227,478 people, up from 79,391 in October.

California, which is running its own program, led the nation, with more than 107,000 signups. Oregon, also running its own market, had the lowest total, with just 44 people enrolled.

Nonetheless, state Medicaid directors are reporting accuracy problems with information on prospective enrollees that the federal government is sending them.

The administration report comes as Sebelius returns to the House Energy and Commerce Committee on Wednesday morning for another grilling from Republicans committed to repealing the law, not to mention Democrats angry over a rollout Sebelius herself called a debacle.

Lawmakers have questions about how and why HealthCare.gov did not work as advertised, whether the federal website meets government security standards and how much all the repairs are costing.

Although Republicans have called for Sebelius to resign, and some Democrats have urged Obama to fire those responsible, the White House has given no indication that a house-cleaning is coming. The secretary’s unusual pre-dawn announcement of an inspector general probe indicates that she realizes she has some explaining to do.

“I believe strongly in the need for accountability, and in the importance of being good stewards of taxpayer dollars,” Sebelius said in her announcement. The website has cost taxpayers more than $600 million so far, according to the congressional Government Accountability Office.

In addition to the inspector general review, Sebelius said she has ordered the hiring of a new “chief risk officer” at the Medicare agency, which also oversees the new programs created to expand health insurance coverage under Obama’s law. That official will focus on making sure technology programs work as advertised.

Sebelius also said she’s ordered a retraining of her department on best practices for outside contracting.

The site went live on Oct. 1 and immediately turned into an impenetrable maze for most consumers. A two-month program of fixes directed by White House troubleshooter Jeffrey Zients stabilized the site and made it more workable, resolving hundreds of software glitches and adding more hardware to handle high demand from consumers.

Zients also found that the technical problems were compounded by inadequate oversight and coordination among teams working for the government and its contractors. That raises questions about how Sebelius and her subordinates have managed the complex program. Through the summer and into the fall, the secretary had repeatedly assured Congress and the public that the insurance markets would open for business on schedule Oct. 1.

With his poll ratings in a dive, Obama not only accepted the blame for website woes, but personally apologized for the canceled individual insurance policies. The cancellations issue is highly sensitive politically because it contradicts Obama’s promise that if you like your coverage you would be able to keep it.

The president sought to calm the backlash by allowing states and insurers to extend existing plans for another year. Thirty-eight have done so, according to analysis by the consulting firm Avalere Health. But it’s unclear to what extent insurers have taken advantage of the leeway granted by state regulators.

The administration had set a goal of signing up 7 million people by the end of open enrollment season March 31. HHS health reform director Mike Hash says they’re still “on track” to meet it. Uninsured people who procrastinate beyond that date will face tax penalties when they file their returns for the 2014 tax year.

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