The new federally-run health care marketplaces created by the Affordable Care Act officially went online at healthcare.gov at midnight on Tuesday, Oct. 1. Day one was marred with glitches, and few – if any – were able to log on to the federal marketplace to begin searching for health insurance plans nationwide.
By the end of the week, the website's technical issues had not been solved. The U.S. Department of Health and Human Services attributed the problems to a "tremendous volume" of traffic at the website.
Over the course of the week, the BizTimes editorial team attempted to log on to the website to learn more information about the new marketplaces. After running into several error messages on various attempts, we were eventually able to create an account, but were not able to fully log in to the online marketplace.
Stephanie Smiley, communications director for the Wisconsin Department of Health Services (DHS), said that was a common problem across the state. Three days into open enrollment, she said she did not know of a single Wisconsin resident who had been able to sign up for health insurance at healthcare.gov.
"So far, folks are getting caught up in the first stage of the application process," she said. "We've not heard from anybody across the state that has been able to get beyond the first stage."
Smiley also said she learned that the healthcare.gov site had more than 7 million hits in the first three days of open enrollment.
In the months leading up to Oct. 1, states were given a number of choices as to how they would implement the Affordable Care Act (ACA). One of these choices was whether a state would run its own marketplace or choose to have those marketplaces be federally-run. In Wisconsin, Gov. Scott Walker joined many other Republican governors across the country to opt for the federally-run exchanges.
In total, 27 states have federally-run exchanges, 17 have state-based marketplaces and seven have partnership marketplaces. Many of the states with state-based marketplaces ran into similar online glitches and technical problems to what was seen in the federal marketplace. However, states such as California and Kentucky, which have state-run marketplaces, had reported that residents were able to apply for health insurance on the marketplaces during the first week.
Minnesota is another state with a state-run marketplace, called MNSure. Minnesota officials are now touting their exchange as a competitive advantage over Wisconsin in health care.
"State-based health insurance marketplaces like MNsure make sense for more reasons than just low rates, however. When there's a problem, it is good to know we can dial a local number, not one with a Washington, D.C., area code," said Minnesota State Rep. Joe Atkins (D-Inver Grove Heights), who was the chief author of the Minnesota exchange law. "If we had done nothing and allowed the federal government to put in a top-down exchange – every Minnesotan using MNsure would be paying more and getting less, just like Wisconsin residents are now seeing."
Wisconsin's neighbor to the west also differs with the Badger State in one of the other choices involved with the ACA's implementation – a federally-funded expansion of Medicaid. Wisconsin opted out of the Medicaid expansion, while Minnesota opted in.
The decision by Wisconsin Gov. Scott Walker is creating changes in the state's BadgerCare program. Though people making 100 percent of the federal poverty level will be covered without the expansion, BizTimes reported in August that Wisconsin will be cutting 92,000 people from the current Medicaid program, more than any other state.
The DHS sent letters to an estimated 92,000 Wisconsinites in September, notifying them that they no longer will be eligible for health care insurance coverage through the state's BadgerCare Plus Program, and is encouraging those people to enroll in the federal health insurance marketplace instead. DHS will also be making outbound phone calls to people on BadgerCare to ensure people have been made aware of the changes, said Smiley.
"We are focusing our efforts on the people who were on our programs so they understand what they need to do and do not go uninsured," she said.
Smiley said that children and pregnant women will still be eligible for Medicaid up to 300 percent of the poverty level. Others who were on BadgerCare Plus will be shifted to the federally-run marketplace.
In total, said Smiley, that means that "around 700,000" Wisconsin residents are expected to sign up for health care insurance coverage through the new federally run marketplace. That number includes people who are shifting from the BadgerCare program to the marketplace, people who are currently uninsured, as well as people who may have some incentive to explore the option of signing up for insurance on the new marketplace.
In the Milwaukee area, said Smiley, the DHS is working at Milwaukee Enrollment Services in assisting people with their applications, and that a group called the Milwaukee Health Care Partnership is working as a convening force for advocacy groups, health care providers and hospitals in Milwaukee enrollment services.
In addition to the online marketplaces, people can apply for coverage in Milwaukee at the Marcia P. Coggs Human Services Center, 1220 W. Vliet St., said Smiley.