Portal back; Arkansas 5 send questions to Sebelius

The federal government’s online portal allowing people to sign up for subsidized coverage went back online Monday, a day after enrollment through the portal - as well as through independent state websites - was halted by the failure of a component of the computerized system.

Meanwhile, the Republican members of Arkansas’ congressional delegation on Monday sent a letter to Health and Human Services Secretary Kathleen Sebelius asking how many Arkansans had enrolled in coverage through the state’s health insurance exchange as of last Friday.

“While regrettable, the disastrous rollout of the Obamacare exchanges is somewhat fitting for the hastily passed law,” the letter says. “But it’s nonetheless unacceptable that the design and deployment of the exchange websites failed to meet even minimal expectations in an economy where Internet-based commerce is commonplace.”

The federal portal was meant to allow people in Arkansas and 35 other states to compare plans offered on health insurance exchanges set up under the health-care overhaul law, apply for subsidies and sign up for coverage.

The other 14 states opted to set up their own websites.

Since enrollment in the exchanges began Oct. 1, the federal site has been plagued by glitches that prevented many users from being able to access its key features.

On Sunday, enrollment through the site stopped altogether after the data hub that routes applicant information to it failed.

The data hub center, operated by Verizon Communications Inc.’s Terremark unit, lost connectivity after workers tried to replace a broken networking component. As of 7 a.m. Monday, the hub was “fully operational,” according to an emailed statement from Joanne Peters, a spokesman for the Department of Health and Human Services.

For at least a day, a note on the federal website told visitors that the system was down.

In addition to asking how many Arkansans have enrolled in coverage, the letter from Sen. John Boozman and Reps. Tom Cotton of Dardanelle, Steve Womack of Rogers, Tim Griffin of Little Rock and Rick Crawford of Jonesboro asks for any correspondence between Sebelius and “stakeholders in Arkansas” about “the status of the exchanges leading up to their launch on October 1, 2013.”

The letter also asks for correspondence between Sebelius and the Arkansas Insurance Department on the effect the federal Department of Health and Human Services’ regulations would have on the number of companies offering health insurance in Arkansas.

The letter asks Sebelius to contact the congressional members’ offices if she cannot provide the requested records by Friday.

Arkansas’ exchange is expected to make subsidized coverage available to about 500,000 people.

The expansion of the state Medicaid program approved by the Legislature this year is expected to extend eligibility for the insurance program for the poor to about 250,000 adults 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 will be able to sign up for a private plan on the insurance exchange and have their premium paid by Medicaid, while those with exceptional health needs will be enrolled in the traditional Medicaid program.

Those who don’t qualify for Medicaid but have incomes of less than 400 percent of the poverty level - $45,960 for an individual or $94,200 for a family of four - may qualify for federal tax credits to help pay their premiums.

The letter from the Arkansas’ Congress members says the federal law has resulted in less competition among insurance companies in Arkansas and higher premiums for families.

Cotton spokesman Caroline Rabbitt said that contention was based in part on a comparison of the rates for plans offered by Arkansas Blue Cross and Blue Shield in 2012 and this year, compared to the companies’ plans offered on the exchange.

For instance, she said, for a Blue Cross policy with a $2,500 deductible, a 30-year old man would pay about $65 month this year.

On the insurance exchange, a person of the same age would pay an average of about $272 a month for Arkansas Blue Cross’ Silver 2500 plan, which also has a $2,500 deductible.

Insurance company representatives have said the higher rates are due in part because the companies can no longer turn down people based on their medical history for coverage starting in 2014 or later.

Insurance companies also are prohibited from charging women more than men, and they are limited on how much more they can charge older people than younger people. Insurance plans also must offer some benefits, including coverage for maternity care and therapy for the developmentally disabled, that most plans in the individual market haven’t covered in the past.

The largest insurance providers in Arkansas’ individual insurance market - Arkansas Blue Cross and Blue Shield, United Healthcare and Qualchoice Health Insurance - have said that people currently enrolled in the companies’ plans will be able to stay on them until Dec. 31, 2014.

Rabbitt also noted that in 24 of the state’s 75 counties, Arkansas Blue Cross and Blue Shield and the national Blue Cross and Blue Shield Association are the only companies offering plans on Arkansas’ exchange, meaning those counties have “effectively no competition between providers.”

“For months, our office has been hearing from constituents who are seeing their hours cut, their premiums rise, and their insurance change or cut as a result of Obamacare,” Rabbitt said in an email. “Since the open enrollment period began, those calls have only increased.

“Many share Congressman Cotton’s fear that the online exchanges are only the tip of the iceberg when it comes to the problems with this unworkable law.”

Michael Teague, spokesman for U.S. Sen. Mark Pryor, a Democrat who faces an election challenge from Cotton next year, called the letter from the Republican Congress members “a combination of untruths and gross mischaracterizations.”

He referred to Census Bureau figures showing that three-fourths of Arkansans are covered by insurance from their employer, Medicaid or another public program and won’t be affected by the rates on the insurance exchange. Most people buying plans on the exchange, meanwhile, are expected to qualify for subsidies, he said.

Arkansas Insurance Commissioner Jay Bradford said the exchange is fostering more competition in a state where a few companies have dominated the market.

At the end of 2012, more than 76 percent of the 117,925 people with plans in the individual insurance market were covered by Arkansas Blue Cross and Blue Shield.

United Healthcare’s Golden Rule Insurance Co. subsidiary had the next highest share of customers, with less than 8 percent of the total, followed by QualChoice, which had 5.6 percent. No other company had more than 1 percent of the total.

On the exchange, Arkansas Blue Cross and Blue Shield and the national association are offering plans in every county.

QualChoice is offering plans in 51 counties, and Centene Insurance Co.’s Arkansas Health and Wellness Solutions is offering plans in 29 counties.

Bradford said he expects United Healthcare and other companies to offer plans on the exchange in future years.

“Probably once it settles down, it will be a stable climate for insurance companies,” he said.

Information for this story was contributed by Alex Wayne of Bloomberg News.

Front Section, Pages 1 on 10/29/2013

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