JEFFERSON CITY, Mo. — Exchanges where uninsured Americans can comparison shop for health insurance through the Affordable Care Act opened up exactly one week ago, the same day as the Federal government shutdown due to a Congressional budget impasse.
But shutdown or no shutdown, the exchanges remained open, even with some Missouri lawmakers like Republican Lt. Governor Peter Kinder calling on Missourians to avoid the exchanges, the process has begun.
Cover Missouri, a coalition of healthcare advocates, is one of several organizations seeking to spread awareness of the exchanges and help Missourians find designated “navigators” tasked with helping people use the system.
Jen Bersdale, executive director of Missouri Health Care for All and a member of Cover Missouri, says awareness was exceeding expectations but that technological snafus have slowed the process.
Missourians seeking to use the exchanges must use the website run by the Federal government, as 62 percent of Missourians voted in 2012 to bar Gov. Jay Nixon from establishing state-based insurance exchanges. This website has been plagued with technical failures since its launch.
For several days, entire swaths of the site were unusable, signups slowed to a trickle and, over the weekend, federal workers were scrambling to increase server capacity and work out the kinks.
The website was also designed to automatically transfer users to state websites if they were eligible for Medicaid, but currently, it is failing to do so. While the federal site struggles to send data to Medicaid portals, Missouri’s website for Medicaid signups is working fine, according to state officials. More than 900 people have already signed up for Medicaid according to reporting from the Post-Dispatch.
Medicaid signups are expected to increase, along with private insurance, even in states where Medicaid expansion has stalled, like Missouri. This is because of the ACA’s individual mandate that all citizens carry some form of health insurance.
“The good news is that we’re seeing these problems because there is so much interest,” Bersdale says. “People are excited about these new options available to them as consumers and the traffic and the interest simply wasn’t anticipated.”
Bersdale says much of the website functionality had returned but that occasional technical delays were to be expected. She also rejected the premise that the website’s failures were a reflection on the failure of the ACA or public policy.
Lt. Gov. Kinder tells The Missouri Times that the failures of the federal website are just one of many problems plaguing an “incredibly flawed” law.
“This whole thing is a catastrophe,” Kinder says. “If [Secretary of Health and Human Services] Kathleen Sebelius was a CEO for a private company, she would have been fired for this mess.”
Kinder chided Sebelius for failing “after three and a half years” to roll out a functioning website and reiterated his call on Missourians to “resist” using the exchanges.
“We don’t know what kind of privacy Missourians are going to be giving up using these broken websites,” Kinder says. “Who are these navigators? Have they received proper training? Are they former ACORN employees or former DNC employees? I see no promise of privacy in using these exchanges and I don’t think Missourians or Americans have the promise of security and privacy when it comes to their own healthcare information. It’s a complete failure.”
And while Kinder joins his Republican colleagues nationally in citing the failures of the federal exchange website as a sign that the ACA is not fit for public consumption, Democrats and those working to bring people to the exchanges insist that the glitches are a temporary setback to a promising program.
“iPhone technology was riddled with problems when they were first released,” Bersdale says. “But I don’t think anyone here would argue that iPhones weren’t ultimately a successful product.”
Some consumers have given up on the exchanges for the time being, resigning to return to the site in a few weeks when things are running more smoothly to sign up, according to Bersdale.
Some may be pushed away altogether, but the exact number of Missouri signups for private insurance through the federal exchange website won’t be known until November, when the Department of Health and Human Services — which is tracking signups nationwide — has promised to release figures.
Calls to HHS about early Missouri figures were not returned.