Insurance coverage starts under ‘Obamacare’ Jan. 1
By Calvin Woodward
Associated Press
WASHINGTON (AP) — Whether you love it or hate it or are just plain confused by it, you’ve got to give the health care law this much: There’s plenty of drama.
The nail biting goes on. As the clock ticks toward the Jan. 1 start of insurance coverage under President Barack Obama’s big, bold and bedraggled creation, there are inklings it might get a second wind.
But that could turn out to be just hot air.
Time will tell, soon, as policies take effect in new health insurance markets that have been enrolling customers — or trying — for nearly three months.
A look at the law’s broad strokes, its brush with disaster and the roots of a possible rebound:
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THE GOOD
No more denying people coverage when they’ve been sick. No more stratospheric premiums for the previously or currently ill, either. No more cutting off insurance payments because someone has used up a year’s worth of benefits. For all the headaches signing up, questionnaires are also notable for questions they do not ask: Have you been treated for cancer? What is your medical history? It won’t matter anymore.
Few in the polarized debate over the health care overhaul defend the history of an insurance system that can drive people into poverty when they get sick or steer them away from treatment.
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THE BAD
More than 4 million people lost coverage because their policies fell short of new federal standards. Far fewer gained insurance in the new markets in that time. This happened despite Obama’s repeated and now discredited pledge that people happy with their insurance could simply keep it. He partnered that assurance with a promise that people happy with their doctors could keep them, too. Not so, in many cases. Another rude awakening.
After a wave of cancellations, the government revised its rules on substandard policies to let insurance companies offer them for one more year. It’s not clear how many plans will be retrieved from the dustbin as a result.
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THE UGLY
Ugly goes to HealthCare.gov, the federal government’s buggy online insurance portal, impenetrable for weeks for many if not most who tried to see what plans they could choose from and perhaps sign up for one.
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THE UNRAVELING
Washington can put a positive spin on almost anything, and federal officials did just that at the very start. Yes, HealthCare.gov is buckling under the user load. That’s because folks love it!
The smiley face soon melted into a swamp of recriminations. Led by Republicans, of course, who feigned indignation that the law many of them despise wasn’t working out so well. A more authentic response came from Democrats: the heebie-jeebies. They’d gone to bat for the law in the mighty struggle to pass it in 2010 and faced down all efforts that followed from the GOP to repeal it. With elections coming next year, Democrats are not happy.
On opening day, Oct. 1, some 3 million people had tried to access the site. Merely six people signed up for coverage, according to a congressional committee’s documents. “No excuse for it,” Obama said, repeatedly vowing to fix it.
No one has been fired. When GOP Rep. Marsha Blackburn of Tennessee asked who’s to blame for the “debacle,” Health and Human Services Secretary Kathleen Sebelius replied, “Hold me responsible for the debacle.”
So everyone, rather unusually, was on the same page in sizing up the launch, or at least they were on the same word. It was a debacle.
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THE IMPROV
Seat-of-the-pants patches, pivots and delays began before the debut of the woebegone 1.0 website and spread well beyond it.
In July, the government postponed one of the law’s central features for a year — the mandate that all businesses employing 50 or more people provide health coverage or risk a penalty.
In late November, it announced a one-year delay in the online marketplace for small businesses to find coverage for their employees. Meantime, insurance companies were sending out cancellation notices for more than 4 million individual policies that didn’t meet new federal requirements, prompting an about-face by the government. Federal officials decided these substandard policies could exist for one more year. It remains to be seen how many canceled policies will be revived as a result.
Then there was the paper-phone-Web conundrum.
With the online system ailing, Obama urged people to apply by mail and phone and used the megaphone of the presidency to give out the toll-free number, 800-318-2596.
But snail mail, if helping in a pinch, wasn’t proving to be an efficient substitute for the streamlined process envisioned by the law. The same week that federal health officials told reporters there were no problems with paper applications, they were quietly discouraging further use of paper in contacts with enrollment counselors, insurance brokers and others.
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THE REBOUND?
On Dec. 1, the government reported progress fixing the website. Now people had a 19-in-20 chance of finding it in operation. You could click more than 99 times out of 100 and not see pages crash. Some 50,000 people could use it at once. But did that mean smooth signups? Not necessarily.
By the middle of the month, things were looking up, though not rosy.
On Dec. 20, Obama said more than a million people had been able to sign up for coverage, a big improvement over the 365,000 who’d had coverage three weeks earlier. But even as he announced the new number at a news conference, some applicants were having problems with the website.
Officials are braced for a late surge of insurance hunters. And for the 2014 installments of a drama seemingly without end.
