(NBC NEWS) -- The Obama administration may be in hot water over its jammed-up
health insurance websites, but the federal government did plan for some
trouble, paying for thousands of specially trained guides called
navigators to help people negotiate the treacherous waters of health
But, three weeks into the most important phase of
health reform, these experts aren't faring much better than average
civilians in getting the site to work.
"Can we just see if it
works?" Amine Ashkar pleads as he tries to sign up for health insurance
at the Community Clinic, Inc. in Wheaton Md. on Wednesday afternoon. "We
can try," answers Martha Lopez, a former insurance agent who's helping
The screen gets stuck as she tries to set up an
account for Ashkar, a 32-year-old bus driver who's looking for a better
deal on his insurance.
Lopez and her team of fellow navigators
employed through the nonprofit clinic have been unable to complete a
single enrollment online.
"Why don't we try next week?" Lopez asks Ashkar. It's not the first
time Lopez has sent a client away. The day before she thought she got
one couple signed up before the website fizzled. "I told them to call
back in 10 to 12 days."
The main goal of the 2010 Patient
Protection and Affordable Care Act was to help get health insurance to
the estimated 47 million Americans who don't have it, either by
extending Medicaid or by giving them access to commercial, private
insurance sold through health insurance marketplaces called exchanges.
must sign up by Dec. 15 in order to get care that begins Jan. 1. But
people have until March 31 to enroll for insurance that starts in 2014.
Still, consumers trying to enroll on their own online have been complaining loudly about how difficult it is. But even the pros are having trouble.
IT system is so messed up at the moment," says Wendy Korrick, who leads
the team of in-person navigators working through the clinic's network.
federal government promised easy, Expedia-style websites where people
were supposed to be able to sign up in a single online session, pick a
plan, find a premium, figure out if they could get a subsidy. That's
what Ashkar is hoping for. He has health insurance through the state,
but he estimates he pays $250 a month for a plan that covers himself,
his wife and his two children, and he has heard he might do better with a
federally subsidized plan.
But the federally run sites in 34 states have been balky at best. Website signups have been almost as bad in some of the states running their own exchanges, too.
On Monday, President Barack Obama admitted the sites weren't working as planned and promised to fix them.
In the meantime, Obama advised people to use call centers and get
in-person help from navigators and non-certified workers called helpers
at community clinics nationwide. But for some, that's a dead end for
The navigators and helpers go through 30 hours of training
and take a federally administered test. They receive instruction on
privacy, and must promise to stay free of conflicts of interest.
administration awarded $67 million last August to train and pay
navigators around the country. Maryland gave $24 million in grant funds
to six organizations like Community Clinic, Inc., to get the word out
about the exchanges, encourage and help people enroll. The state has
trained about 5,000 people total, including navigators, insurance
brokers and social workers, to help people sign up.
Potomac River in Virginia, there are far fewer navigators. Virginia
opted to let the federal government run its exchange, and much of the
work has fallen to non-profit groups.
After complaints by
Republicans that navigators might not have enough training, or might
have access to personal information, states including Utah, Nevada and
Georgia passed law calling for stricter certification and licensing.
Healthworks, a system of community health centers in Virginia, trained
navigators have been able to get a few people signed up on the federal
website. But navigators there have also turned to paper, says Carol
Jameson, associate CEO for the clinics.
"We were going to wait
until the website was up," Jameson says. "Then, when that wasn't
happening, we decided to mail the applications in."
at Community Clinic, Inc., a network of free and low-cost medical
clinics, has talked with 1,300 people so far, Korrick estimated.
not a single one has made it through the entire enrollment process
online. Maryland's website, modeled on the federal website, keeps
One woman got angry at the delays, says Apoorva
Srivastata, who's assigned to a clinic in nearby Takoma Park, Md. "She
was, like, 'I have given up hope,'" Srivastata says. "She had taken
public transport to get there, and she had her kids with her. I told her
not to give up and that she has time."
Srivastata will call the woman when she is sure the website will work.
Dixon, who spends her days at a folding table with a laptop computer
inside one downtown Silver Spring clinic, has calmed some impatient
customers, too. "I had one gentleman who got pretty upset," she says.
Maryland's case hasn't been a total failure. The Maryland Health Benefit Exchange says
that as of last week, 2,300 households used the website to sign up for
health insurance. About 260,000 have visited the website; Maryland has
800,000 residents without health insurance.
But it compares
poorly to, for instance, the state of Washington, which says more than
35,000 people have successfully signed up on its online exchange.
the time being, the navigators are telling people about the health care
law and their options. Srivastata says she makes her "elevator pitches"
whenever the clinic's waiting room fills up with patients, most of them
recent immigrants from Latin America or Ethiopia.
"I say, 'Do you
know about the new health care law?' and they are all blank," she says.
"I'd say 90 percent of people are at point zero."
about the Affordable Care Act usually get a shrug, says Dixon. "But if
you say Obamacare, they say "yeah, oh, yeah, Obamacare," she says.
remains hopeful. "It's better than it was last week and I fully expect
for it to get better next week," Dixon says, nodding. In the meantime,
she's telling people to make appointments for two weeks from now.
in Congress say they believe the Obama administration knew about the
problems and didn't tell anyone. On Thursday, the Republican-controlled
House Energy and Commerce Committee will hold a hearing on
the technical problems and has summoned executives from several of the
software contractors who helped build the federal exchange.
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Maggie Fox, NBC News