More than 600,000 uninsured Virginians are eligible for subsidized health plans through the state's federally run insurance marketplace, but one month into the signup computer glitches continue to thwart potential enrollees on the Peninsula as elsewhere.
On Oct. 1, the first day to enroll through http://www.healthcare.gov, more than 220 people sought help at "Enrollfest" in Hampton. Thirteen people were successful, according to event organizer, Gaylene Kanoyton.
This week, Sylvia Whitaker, a certified application specialist with the Southeastern Virginia Health System, expressed frustration about the website's problems, but she remained undeterred about the importance of access to affordable insurance for all.
"We have so many uninsured here at our centers. One person got through online and learned about her premium and tax credit today," Whitaker said Wednesday. She has set a goal of four online applications a day for the application counselors spread across the health system's eight locations.
"We give it 90 minutes per person," she said, describing the patience required as "the wheel turns and turns" on the screen. "When it's up and running right, it's so straightforward and easy. It's very user-friendly and very non-intrusive, it just requires your income."
The state insurance marketplaces are at the heart of the 2010 Patient Protection and Affordable Care Act, better known as Obamacare or federal health-care reform.
As part of the gradual phase-in of the bill's requirement that every U.S. resident have health insurance starting in 2014 (the so-called "individual mandate") the marketplaces, formerly called exchanges, are intended to plug the gap between those eligible for expanded Medicaid and the private health insurance market.
The marketplaces are government-operated — either by individual states or the federal government — but the plans offered are through private insurance companies.
Those with incomes up to 400 percent of the federal poverty level, FPL — $46,000 for a single person and $94,000 for a family of four — qualify for subsidies, or "tax credits," for their premiums. Those making up to 200 percent of the FPL also qualify for help with deductibles and co-pays. For higher-income individuals, insurance companies offer more choice outside the marketplace.
No one has been able to explain the extent of the problems with the online application system. From President Barack Obama to Secretary of Health and Human Resources Kathleen Sebelius to Medicare chief Marilyn Tavenner, all responsible have conceded that the rollout of the state insurance marketplaces has been unacceptable and even "a debacle." Blame has gone full circle, from an initial overload of the system by an enthusiastic public to the incompetence of the various site contractors.
This week, representatives of the U.S. Department of Health and Human Services declined to give enrollment numbers, but promised a smoothly running online program by the end of November. The newly upgraded site can now accommodate 17,000 registrations (the first step to enrollment) per hour, said Julie Bataille, communications director of the Centers for Medicare & Medicaid Services in a conference call Tuesday, while acknowledging ongoing problems with completing the process.
Though the enrollment period extends through March, the deadline is Dec. 15 to sign up for coverage that will begin Jan. 1, 2014.
Heather Parsons, a Hampton-based enrollment "navigator," funded with a grant through the Virginia Poverty Law Center, conducts educational outreach across Hampton Roads and also assists people one-on-one with applications. She doesn't have any numbers, but stresses that those doing paper applications — an alternative to the online process — shouldn't wait in order to meet the deadline. She distributes the forms from her office and they're also available from the Department of Social Services, she said.
Whitaker also encourages people to take advantage of the alternatives to online applications. "The federal call center is very quick — less than a minute — to get through," she said. People can enroll directly by phone or just get advice.
Potential enrollees can also pick up paper applications at the Southeastern Virginia Health System's clinics, or print them from online. Whitaker advises people to ignore the initial calculator for fear that the premium prices cited will prevent them from completing the process.
"There's no consideration for tax credits or cost-sharing in the calculator," she said. As an example, she cited one successful applicant whose initial premium showed up as close to $500, but that was reduced to $180 a month by subsidies, in addition to her being eligible for cost-sharing help with the deductible and co-pays.
"We don't consider it a struggle. We have options," said Whitaker.
Salasky can be reached by phone at 757-247-4784.
• To apply online, go to http://www.healthcare.gov
• For help, or to apply by phone, call 1-800-318-2596.
• Statewide toll-free number is 888-392-5132, or http://www.enroll-virginia.com.
• For navigator help, call Heather Parsons, 757-275-0125 to schedule an appointment, email@example.com. Parsons will present an information session, 6-7:30 p.m., Tuesday, Dec. 3, at Main Street Library, 110 Main St., Newport News; call 757-591-4858 for more info.
• For certified application counselor help, call the Southeastern Virginia Health System, 757-380-8709, to find the location nearest you.
• Paper applications are available at Department of Social Services offices, from Heather Parsons, and from Southeastern Virginia Health System clinics throughout the region. They can also be printed from online.