In March, Henry Chao, the chief digital architect for the Obama administration's new online insurance marketplace, told industry executives that he was deeply worried about the Web site's debut. "Let's just make sure it's not a third-world experience," he told them. Two weeks after the rollout, few would say his hopes were realized. For the past 12 days, a system costing more than $400 million and billed as a one-stop click-and-go hub for citizens seeking health insurance has thwarted the efforts of millions to simply log in. The growing national outcry has deeply embarrassed the White House, which has refused to say how many people have enrolled through the federal exchange.
South Florida consumers who are able to penetrate the "Obamacare" computer system are sorting through dozens of health insurance plans and finding some of the lowest — and some of the highest — premiums in the country. The result is an odd mix of sticker shock and pleasant surprises. After bumping into the usual error messages during six days of failed attempts, Ed Davis, 55, of Coconut Creek, finally got into Healthcare.gov, the government website for buying insurance, and immediately liked what he saw: 132 plans at a range of prices. He picked an Aetna plan that offers a $6,000 deductible, $20 co-pays for primary-care visits and $10 co-pays for generic drugs — all at $327 a month after applying a tax credit that reduced his cost by $165.
Hospitals, a reliable source of employment growth in the recession and its aftermath, are starting to cut thousands of jobs amid falling insurance payments and inpatient visits. The payroll cuts are surprising because the Affordable Care Act (ACA), whose implementation took a big step forward this month, is eventually expected to provide health coverage to as many as 30 million additional Americans. "While the rest of the U.S. economy is stabilizing or improving, health care is entering into a recession," says John Howser, assistant vice chancellor of Vanderbilt University Medical Center.
Today's door-to-door insurance salesmen may seem worlds apart from the residents of these often-tattered row houses, but they share one big thing in common. They haven't been able to afford insurance either. They face the daunting task of helping to convince the nearly 200,000 uninsured residents of Philadelphia County that they can — and should — buy it now. The new exchange's success, the cornerstone of the Affordable Care Act, will hinge on whether it can meet the federal goal of 7 million enrollees, but also on whether it can sign up enough healthy younger people like these canvassers to make up for all the ailing older ones.
These first two weeks have been rocky for the state health insurance exchanges. The online marketplaces opened across the country Oct. 1, with computer glitches and staffing shortages. Even the states that have agreed to run their own are having a hard time. In states that have not embraced the Affordable Care Act, the federal government is struggling to fill in the gap. As Alexandra Dixon threads her way among the people waiting to see a doctor at the Community Clinic, Inc., in Silver Spring, Md., she introduces herself with a bright smile and an outstretched hand.
Consumers shopping for health coverage in new online marketplaces may scratch their heads when they come to a handful of plans in Virginia: Why do some cost more than $1,800 a month? No, the plans do not include gold-plated hospital beds or guaranteed same-day access to doctors. Instead, those premiums reflect an add-on benefit for a type of costly surgery for obesity which makes them up to six times more expensive than plans without such coverage. That means a Virginia consumer considering gastric bypass or bariatric surgery will have to pay up to $1,500 a month more for plans that cover the procedure.