Public turnout in the Triangle was spotty among last-minute shoppers for subsidized health insurance on the eve of a major milestone for the Affordable Care Act.
Local nonprofits that enroll clients did not experience anticipated backlogs in the days leading up to Tuesday’s enrollment deadline. Trained insurance “navigators” from the CapitalCare Collaborative sat idle for several hours at the Pullen Memorial Baptist Church in Raleigh after clients failed to show up Monday afternoon for their scheduled tutorials on subsidized insurance.
At the Blue Cross and Blue Shield sales center in Morrisville, which remained open Tuesday to handle 11th-hour enrollments, customers trickled in during the day.
The irregular customer turnouts and no-shows at some enrollment sites suggest that North Carolina’s enrollment tally could fall short of expectations when updated enrollment figures come out in mid-January. Fewer than 9,000 had enrolled in the state during October and November out of more than 1 million who had been expected to shop for subsidized insurance.
Blue Cross CEO Brad Wilson, who dropped by the Morrisville store Tuesday, said those who are enrolling so far tend to be older and sicker people who haven’t been able to afford insurance, rather than people who have gone without coverage by choice.
“My guess is that those who need the coverage the most have been most persistent in trying to get the coverage,” Wilson said.
The final enrollment deadline is March 31 for coverage in 2014, which means that a late surge of applicants is still a possibility. Federal officials reported a crush of online traffic on the federal enrollment website on Monday and Tuesday, but it’s not clear how many logged on from North Carolina.
‘Nowhere near perfect’
The run-up to the Tuesday deadline was closely watched as a major test of the new law. The crash-prone healthcare.gov had undergone extensive repairs since its ill-fated launching in October; in a last-minute move, federal officials extended the enrollment deadline by 24 hours, from midnight Monday to midnight Tuesday.
Wilson said the problems are far from over. He said “a good number” of applications still have to be manually fixed before they are valid. Some applications aren’t being handed off to the insurer; others arrive incomplete or with errors. In some cases, customer payments are getting delayed.
Blue Cross, the state’s largest health insurer, has brought on teams of contractors to reconcile the applications and make sure they can be processed in time, Wilson said. Customers who completed applications by midnight Tuesday will qualify for subsidized insurance coverage Jan. 1 but have until Jan. 10 to submit their January payment.
“The system has improved, but it’s nowhere near perfect,” Wilson said. “We shouldn’t fool ourselves that Jan. 1 is somehow magically going to be perfect.”
At times Tuesday, the enrollment website was so bogged down that several customers gave up and walked out of the Blue Cross sales center.
Blue Cross officials here are not providing a running tally on customer enrollments but will disclose their subscription total after open enrollment season ends March 31.
Blue Cross is one of just two insurers offering subsidized coverage under the new health care law in North Carolina. Blue Cross operates in all 100 North Carolina counties, while Coventry Healthcare of the Carolinas is in 39 counties.
The Affordable Care Act requires most Americans to have health insurance as of Jan. 1, but the majority already have coverage through their employers or through government programs like Medicare and Medicaid. Those who are most directly affected are the uninsured as well as people who buy individual policies.
The new health care law provides subsidies, on a sliding scale, to people within certain household income limits. Those who don’t qualify for subsidies have complained about the high costs of the new insurance plans.
Some customers said they were able to log on and complete the process without hiccups.
Joyce Magierka of Wilson said it took just 15 minutes to complete her application with the help of an insurance agent at the Blue Cross store in Morrisville.
Magierka, a security guard who makes about $16,000 a year, had tried to use the website on her own but said it was too confusing. On Tuesday, she signed up for a heavily subsidized Blue Cross policy for less than $40 a month, with a $500 deductible.
“You don’t want to pay the penalty,” she said. “Who can afford that?”
The insurance law’s penalties, to be taken out of tax refunds, apply to those who don’t have insurance and are not exempted from coverage. In 2014, the fine will be $95, or 1 percent of annual income, whichever is greater. The penalty increases in subsequent years.
Heather Bailey of Durham was one of the 11th-hour enrollees who found out on deadline day that her online application was defective.
She said she had spent 12 hours online on Monday, contending with an uncooperative website, and came to the Blue Cross store Tuesday to verify that her online application went through.
“I was on from 10 o’clock in the morning to 10 o’clock at night,” she said. “I had a headache, I was miserable.”
At Blue Cross, Bailey learned that she had inadvertently enrolled for a Blue Cross plan in Wake County, and would not have been accepted within the Duke University provider network closer to her home.
The private duty nurse currently pays about $469 a month for insurance, with a $5,500 deductible. She signed up for a subsidized policy that will cost her $347 a month, with a $3,000 deductible.
“I’m grateful for the subsidy,” she said. “I went from miserable yesterday to deliriously happy today.”