HARRISON - A day after federal officials promised that a health-insurance enrollment website would be working smoothly for “the vast majority of users,” the Arkansas Insurance Department on Monday held the first of a series of events it has planned for this month to help people sign up for coverage that will start Jan. 1.
But by the end of the enrollment fair at the North Arkansas Regional Medical Center in Harrison, no one who showed up for help had been able to successfully sign up through the website, healthcare.gov.
Samantha Williams, an outreach worker with Health Resources of Arkansas, said she tried to help a woman use the site soon after the enrollment fair started at noon but the website “just closed on us” after the woman had entered her information.
“It just shut down,” Williams said.
She gave the woman a paper application that could be filled out and mailed to the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services.
“She was happy there was another option,” Williams said.
Julie Bataille, a spokesman for the Centers for Medicare and Medicaid Services, acknowledged Monday “that things are not perfect with the site.” The agency operates the troubled portal under the 2010 federal health-care overhaul law.
By 5 p.m. CST Monday, the website had had close to 800,000 unique visitors for the day- one of the administration’s targets for the site’s performance, according to administration officials. And the site processed 18,000 enrollments in the most recent 24-hour period, nearly double the previous record.
The increased traff ic caused pages to load slowly and the error rate to spike, Bataille said.
About 9 a.m. CST, when the number of people on the site was roughly 35,000 - or 15,000 fewer than administration officials had said it could handle - officials turned on a new queuing system that alerts some visitors to the site to come back later.
In Harrison later Monday afternoon, an outreach worker tried to help a couple with a young child in tow use the website but couldn’t create an account on the site.
The worker said the couple made an appointment with her to try again next week at her office in Harrison.
The website is the portal for people in Arkansas and 35 other states to sign up for subsidized coverage being made available under the 2010 Patient Protection and Affordable Care Act, but the site had been hampered by software flaws and other problems since the start of the Oct. 1 enrollment period.
The other 14 states are operating their own enrollment websites, at least some of which have worked better than healthcare.gov.
President Barrack Obama in October promised a “tech surge” to fix the website, and officials said they expected it to be working smoothly for the “vast majority” of users by Saturday.
Federal officials said Saturday that the website had improved but the work is ongoing.
While outreach workers encountered problems with healthcare.gov in Arkansas on Monday, the website’s performance has improved over the past two weeks, Insurance Department spokesman Heather Haywood said.
She said people who have gotten stuck in the application process can try creating a new account using a different email address. Cleaning out a web browser’s cache and browsing history may also help, she said.
Kalena Jones, director of the Arkansas Health Care Access Foundation, said her organization’s outreach workers have been having a “9 out of 10” success rate using healthcare.gov in the past few weeks.
At an enrollment event at Pulaski Technical College last month, the workers enrolled more than two dozen people.
About a dozen were enrolled through healthcare.gov, and the others went throughaccess.arkansas.gov, she said.
“For the most part people have been very satisfied,” Jones said.
At the event in Harrison, most of the 10 individuals or families who attended the event before it ended at 6 p.m. simply wanted more information about the health-care law and their coverage options, outreach workers said.
Sue Anderson, 61, who lives in the Low Gap community near Jasper, fell into that category.
She said she’s hasn’t had insurance for 25 years and pays for her medical care out of her own pocket. That included a hysterectomy in 2001 that took her seven years to pay off.
She would like insurance, she said, but has been turned down because of her high blood pressure. Still, she said she doesn’t think the government should require people to buy insurance.
After speaking to an outreach worker on Monday, Anderson said she understood her options better.
“I think there are options,” she said. “I don’t know that they’re all good. I have lot of reservations about this whole thing.”
Gail Roberts, also 61, of Harrison said she’s hoping to find coverage for herself and cheaper coverage for her husband, who pays almost $600 a month for coverage through his employer.
She said she was laid off from her job at a bank in October 2012 and her coverage through that job ended at the end of that year.
Like Anderson, Roberts said she hasn’t been able to get private insurance because of a health condition - in Roberts’ case, blood clots in her lungs, arms and legs.
On Monday, an outreach worker told Roberts that the worker would need to do more research on her situation to determine whether she would qualify for subsidized coverage.
Roberts said she made an appointment to speak with a worker again later in the week.
“A lot of this, I don’t understand, so I’m just depending on them,” Roberts said.
Under the health-care law, people with incomes below 400 percent of the poverty level - $45,960 for an individual or $94,200 for a family of four - may qualify for tax credit subsidies to help pay their premiums for private plans offered on health-insurance exchanges.
In addition, the expansion of Arkansas’ Medicaid program, authorized under the health-care law and approved by the Legislature this year, extended eligibility for Medicaid to those with incomes of up to 138 percent of the poverty level - $15,860 for an individual or $32,500 for a family of four.
Most of those who qualify for Medicaid coverage are expected to be able to sign up for private plans on the exchange and have Medicaid pay the premiums. About 10 percent - those identified as “medically frail” because of their health-care needs - will be assigned to the traditional Medicaid program.
As an alternative to using healthcare.gov, people can apply for Medicaid coverage through a state website, access.arkansas.gov or by calling (855) 372-1084.
People also can apply for Medicaid or tax credit assistance by calling a federal call center at (800) 318-2596.
Those who enroll in plans on the state exchange must complete the process by Dec. 23 for the coverage to take effect Jan. 1.
Medicaid will cover up to three months of past medical expenses for those who qualify for that program, however.
Vince Leist, the chief executive officer of North Arkansas Regional Medical Center, said the hospital has trained a half-dozen employees to help people enroll in coverage subsidized by Medicaid or the federal tax credits.
Having more patients covered by insurance would help the hospital financially at a time when its reimbursement from Medicare is being cut, he said.
A 2 percent cut will take effect Jan. 1 in addition to a 2 percent reduction that took effect this year because of automatic federal spending cuts, he said.
“We’re on a razor’s edge,” Leist said.
In addition to the Harrison event, the Insurance Department is planning events over the next two weeks in Walnut Ridge, Mountain Home, Pine Bluff, Searcy, Conway, Hope, Little Rock and Jonesboro.
Information for this article was provided by Noam N. Levey of the Tribune Washington Bureau.
Front Section, Pages 1 on 12/03/2013