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Tough Start To Insurance Marketplaces

Technical glitches made for a rough rollout of the new online insurance marketplaces that went live on Tuesday, as consumers on both sides of the Connecticut River experienced problems creating accounts and shopping for coverage.

Vermont and New Hampshire took different approaches to establishing insurance marketplaces, also known as exchanges, with Vermont opting to design its own system and New Hampshire deferring to the federal government. But on the first day of open enrollment, both had problems with malfunctioning websites.

In Vermont, many individuals and the “navigators” trained to help them were unable to log onto the state-run marketplace, VermontHealthConnect.gov, and begin the process of shopping for insurance. Meanwhile, New Hampshire residents visiting their state’s exchange on HealthCare.gov were greeted with error messages that prevented them from setting up personal accounts.

Officials in both states said that the glitches were expected, and that technicians were working to identify the problems and have them resolved soon.

The health insurance exchanges are a signature piece of the 2010 Affordable Care Act, which was designed to give uninsured Americans greater access to health coverage. Each state has its own online exchange — websites similar to retailers such as Amazon or Expedia but exclusively for health insurance.

Tuesday morning proved to be frustrating for Kathy Castellini, one of hundreds of navigators trained to help uninsured Vermonters access coverage. Five people had scheduled appointments with her Tuesday to enroll in coverage, but Castellini was unable to log on to the website. As a back up, Castellini gave the patients paper applications and told them that they would enroll in several weeks after the glitches had been worked out.

“It was a big expectation to have it all complete and done this morning,” said Castellini, the coordinator of the Windsor Community Health Clinic.

Navigators at Gifford Medical Center also experienced problems using the site and had to reschedule appointments, said hospital spokeswoman Robin Palmer. After contacting the state about the problem, a Gifford navigator was told, “We’re aware of the problem. Check back in 24 hours,” Palmer said.

Still, state and federal officials were quick to praise the “milestone” that had been reached with the launch of the exchange. Robin Lunge, director of health reform in Vermont, said “pretty much things have been rolling out as we expected on day one.” The website was slow and consumers were not able to compare deductibles and out-of-pocket maximums of plans side-by-side, Lunge said, although they could find that information elsewhere on the website. Those who were not able to sign up could still browse the marketplace website to find information.

As of 4 p.m., VermontHealthConnect.gov had 8,500 unique visits and 330 people had created online accounts, according to Emily Yahr, public information officer for Vermont Health Connect. Marketplaces should not be judged on the first day’s experience alone, Lunge said.

“This is an important milestone, but I think it’s important for us to recognize that this is a marathon and not a sprint,” Lunge said. “It’s the beginning of a process.”

New Hampshire also had its share of issues.

Many visitors to the HealthCare.gov website, which is run by the federal government, were unable to create personal accounts online or experienced delays. The website repeatedly displayed messages such as “The System is down at the moment” or notifications that “Your account couldnt (sic) be created at this time.”

The problems belie the confidence expressed by federal officials in the weeks leading up to Tuesday’s launch. In an interview with the Valley News last week, Raymond Hurd, regional administrator for the Centers for Medicare and Medicaid Services, or CMS, said the marketplace would be ready to go online Tuesday.

“All systems are green for Oct. 1,” Hurd said.

Conservative groups were quick to pounce on the setbacks as evidence that “Obamacare” was doomed.

“Obamacare’s failure to launch was as predictable as it was thorough,” said Greg Moore, state director for Americans for Prosperity — New Hampshire, in a statement. “This hurried, incompetent job of trying to implement a badly flawed law clearly demonstrates why the federal government should not be in charge of our health care decisions.”

The problems had nothing to do with the shutdown of the federal government on Tuesday, which was brought about largely because Democrats and Republicans couldn’t agree on funding provisions of the Affordable Care Act. However, the shutdown still hampered efforts to access information about the rollout of the marketplace in New Hampshire.

An email to a Medicare spokeswoman in the Boston regional office was immediately returned Tuesday with an automatic reply that said: “Due to the absence of either a FY 2014 appropriation or Continuing Resolution for the Department of Health and Human Services, I am out of the office on furlough and I am not able to respond.”

During a conference call with reporters late Tuesday afternoon, Medicare officials said consumers were able to enroll in plans through both state-based and federally run exchanges, but would not release details of how many people had successfully signed up. By 4 p.m., the HealthCare.gov website had received 2.8 million visitors, CMS officials said. As for the problems accessing the site, CMS officials said they were working to address the issues.

“With any new product launch, there are going to be glitches as things unfold,” said Marilyn Tavenner, CMS administrator.

Individuals and families who are not offered health insurance through their employer, and businesses with fewer than 50 employees, are able to buy health insurance through the exchanges. People who do not buy insurance face a tax penalty under the federal law, though there are a few exemptions. In Vermont, the exchange will be the only place where individuals and small businesses can get health insurance. But in New Hampshire, insurance plans can still be purchased outside of the market.

Although both marketplace websites experienced high traffic volume, many people are likely to wait weeks or even months before shopping for coverage. People have until Dec. 15 to enroll for coverage that begins on Jan. 1. Open enrollment lasts until March.

Navigators at Good Neighbor Health Clinic, a free clinic in White River Junction, are waiting until next week to meet with uninsured individuals to allow time for the technical problems with the website to be worked out, said Executive Director Armando Alfonzo. In the meantime, the clinic is fielding calls from consumers and steering them toward more information.

“We sort of anticipated that ... it would be a week to work out the glitches,” Alfonzo said Tuesday afternoon. “Nothing is going to be perfect.”

Sharon resident Deb Crown said she is in no rush to enroll. Crown is covered through Catamount Health, a program that will disappear at the end of the year. She still has questions about the cost of coverage and which plan will be best for her. But given that she’s got several months to make the decision, she’s taking her time.

“I’m just going to wait until things settle a bit,” Crown said Tuesday morning. “There’s so much drama around it now. I just thought I’d wait until the dust settles.”

Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.

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