Health IT

Day 1 at the 16 state exchanges: Mostly fair with 6 fails, a lot of “try again later”

It was a good news/bad news kind of day for the state officials leading the 16 health insurance exchanges that launched (or were supposed to launch) yesterday. Thousands of people wanted to sign up for an account and apply for a health insurance policy, but the websites couldn’t handle all the traffic. The federal exchange […]

It was a good news/bad news kind of day for the state officials leading the 16 health insurance exchanges that launched (or were supposed to launch) yesterday. Thousands of people wanted to sign up for an account and apply for a health insurance policy, but the websites couldn’t handle all the traffic. The federal exchange — Healthcare.gov — had the same problem.

Here is a look at the 16 state exchanges that went live yesterday. I have organized the exchanges into three categories:

  • Good — States that were able to keep their websites up most of the day and process at least some applications
  • Fair — States that launched a functioning website but had a lot of down time
  • Poor — States that launched websites that were missing key functionality such as the ability to compare plans or apply online or missed the launch entirely

Open enrollment lasts for the next six months, so states have a lot of time to fix these problems and make the websites easier to use. The next crunch day will be in early December because people have to sign up by Dec. 15 to have coverage that starts Jan. 1, 2014.

Good

California Covered California

From the San Jose Mercury News: On the first day of a six-month open-enrollment period, the Covered California site received 5 million hits by 3 p.m. and averaged 5,000 hits per minute and peaked at 16,000 hits per minute. As of 3 p.m., the two Covered California call centers received 17,000 phone calls — 13,000 more than anticipated. At 8:46 a.m., Covered California tweeted that it had enrolled its first person.

Colorado Connect for Health Colorado

From the Denver Post: Computers handling new volume from the simultaneous Medicaid expansion performed smoothly Tuesday, Colorado officials said, and they were “exceptionally pleased” with first-day performance. Connect for Health, where consumers without insurance go to seek subsidies and buy plans, said 1,450 new accounts were created, and that 57,500 people had visited their website by late in the day. There were also 3,000 calls and chats with customer-service representatives. They said they would release numbers on actual sign-ups for insurance plans only weekly.

Medicaid, which normally processes 30,000 applications a month, took in 3,000 by 11 a.m. with no problems, said Sue Birch, director of the Health Care Policy and Finance department overseeing Medicaid.

Connecticut Access Health CT

From The Connecticut Mirror: The website has been spotty, but Access Health CT enrolled its first member shortly before 9:30 Tuesday morning and had 44 by early afternoon. As of 9 a.m., Counihan said the website had received 110,000 hits Tuesday, including 76,000 from in Connecticut. After the press conference, Counihan said the site had 123,000 visits and the call center also was busy, with a typical call taking 7.5 minutes.

New Mexico Be Well NM

From the Albuquerque Journal: The state’s SHOP site for small businesses enrolled 29 businesses within the first 45 minutes the exchange was open. By noon, they had more than 100 businesses, said Mike Nuñez, interim CEO for New Mexico Health Insurance Exchange. Individuals had to use a federally operated computer system to shop for insurance.

Fair

Kentucky Kynect KY

From The Courier-Journal: By 8:30 a.m., The Kynect website, got 24,000 visitors and had processed nearly 1,000 applications — more than officials expected — when the registration function went down, keeping many from applying for insurance or seeing personalized rates for various plans until it was fixed at 3 p.m. Carrie Banahan, executive director of Kentucky Health Benefit Exchange, said officials had “expected some bumps” as the website went live. By 2:30 p.m., Kentucky’s site had 600,000 page views, with more than 52,000 pre-screenings conducted to determine qualifications for subsidies, discounts or programs such as Medicaid, according to the most current data released by the governor.

Maryland Marlyand Health Connection

From the Baltimore Sun: USA Today: The state marketplace began having problems immediately after its scheduled 8 a.m. launch. Delays continued all day with people still unable to get onto the site by early evening. The site finally found life again at about 12:30 p.m., although a note cautioned people about slowness because so many were trying to gain access and people still reported problems. The first day’s problems were caused by a logjam of people trying to create accounts on the site, said Maryland Health Secretary Joshua Sharfstein. At one point, about 1,000 people a minute were trying to create accounts, he said.

Minnesota MNsure

From The Star Tribune: MNsure didn’t achieve liftoff until a little after 3 p.m., after last-minute testing of a connection with a federal hub. Within the first hour, more than 500 accounts were created, but MNsure officials couldn’t say whether anyone bought policies. A server that helped consumers set up accounts went down early on, which spawned griping on social media from some frustrated users.

Nevada Nevada Health Link

From the Las Vegas Sun: The computer system for the much-praised and much-maligned Affordable Care system in Nevada started 17 minutes late. Jon Hager, director of the Silver State Health Exchange, said the call center opened as scheduled at 8 a.m., but the website was late getting online. Premiums posted today still have to be approved by the companies, which is expected by the end of the week. The out-of-pocket expense details will be available on the website “in a week or two,” Hager said.

New York NY State of Health

From The New York Times: New York said that 10 million attempts had been made to reach its site, although with many people making multiple tries, it was not clear how many individuals that represented. And officials said the figure was so far beyond anything they had considered plausible that they were investigating the cause.

Rhode Island Health Source RI

From Boston.com: The center fielded nearly 1,900 calls by 5:30 p.m. and 30 people visited in person, according to Dara Chadwick, a spokeswoman for the exchange.

Fail

District of Columbia DC Health Link

From The Hill: Washington’s exchange said last week that it will not be ready on Oct. 1 to calculate the tax subsidies people can receive to help purchase private insurance. The D.C. exchange also will not immediately be able to determine eligibility for Medicaid. Washington’s exchange said it will still begin accepting applications on Oct. 1 and will notify applicants of their eligibility determinations in early November.

Hawaii Hawaii Health Connector

From The Garden Island: Hawaii is starting open enrollment under President Barack Obama’s federal healthcare overhaul without consumers being able to compare actual plans and prices. Chief Marketing Officer Rick Budar of the Hawaii Health Connector told The Associated Press on Tuesday that consumers will be able to apply for coverage, but insurers are still testing and reviewing rates in part to make sure they’re shown correctly within the system.

Idaho Your Health Idaho

From The Idaho Statesman: A filtering system to sort plans by cost, prescriptions or providers is delayed, so consumers will have to search each individual plan and take notes to make comparisons. Exchange officials also postponed until November an aggressive television ad campaign urging people to sign up.

Oregon Cover Oregon

From Oregon Live: The exchange went live at midnight, and within an hour the first reported problems started coming in. A common complaint: scrolling through health insurance choices was leading to the message: “Whoops, looks like something went wrong.” In all, programmers dealt with 34 reported issues, two of which were deemed “critical,” said Rocky King, Cover Oregon’s executive director. He said visitors viewed 750,000 individual web pages, which led to some of the error messages. People won’t be able to fully enroll through insurance agents or certified application assisters using the website until as early as this weekend, King said. Agents and application assisters can take applicant information, save it, and provide information on eligibility later.

Vermont Health Connect

From The Rutland Herald: Susan Klein, executive director of the Mad River Valley Chamber of Commerce and one of 250 exchange navigators, said her attempts to access the site Tuesday morning were unsuccessful. The site loaded in the afternoon, but she said she was still unable to register. The website was slow to load — or failed to load — for many people. Officials said heavy traffic on the site was to blame. As of 4 p.m. about 8,500 unique visitors had been to the site. About 600 people had contacted a call center that also launched Tuesday, according to Emily Yahr, a Vermont Health Connect spokeswoman.

Washington WA Health Plan Finder

From The Penninsula Daily News: Michael Marchand, a spokesman for the new health insurance marketplace, said at midday Tuesday that the problem was not related to the volume of visitors or to the federal government shutdown. It was offline for nearly six hours after officials shut it down to assess why it was operating so slowly. The wahealthplanfinder.org website opened again for business just after 2 p.m.

Massachusetts and Utah

These two states have been running exchanges for several years now. Massachusetts launched MA Health Connector in 2006 as part of the healthcare reform law. Because of different federal rules, roughly 150,000 people who got coverage through the state’s exchange marketplace will have to re-enroll to avoid losing coverage next year, state officials said.

In Utah, small business owners can use a state-run exchange, Avenue H. It was launched in 2006.

Fox News has an interesting collection of the error messages that people got yesterday as they tried to use the sites. USA Today reported more details about how the exchanges preformed around the country and WFMY News 2 makes the excellent point that it will be many more months before we can call the exchanges a success or failure.

[Map from the Wall Street Journal]