Updated Healthcare.gov Gets Mixed Reviews

Counselors helping people use the federal government's online health exchange are giving mixed reviews to the updated site, with some zipping through the application process while others are facing the same old sputters and even crashes.

The Obama administration had promised a vastly improved shopping experience on healthcare.gov by the end of November, and Monday was the first business day since the date passed.

Brokers and online assisters in Utah say three of every four people successfully signed up for health coverage on the online within an hour of logging in. A state official overseeing North Dakota's navigators said he had noticed improvements in the site, as did organizations helping people sign up in parts of Alabama and Wisconsin.

But staffers at an organization in South Florida and a hospital group with locations in Iowa and Illinois said they have seen no major improvements from the federal website, which 36 states are relying on.

Amanda Crowell, director of revenue cycle for UnityPoint Health-Trinity, which has four hospitals in Iowa and Illinois, said the organization's 15 enrollment counselors did not see a marked improvement on the site.

"We had very high hopes for today, but those hopes were very much quashed," said Crowell. She said out of a dozen attempts online only one person was able to get to the point of plan selection, though the person decided to wait.

The site appeared to generally run smoothly early Monday morning before glitches began slowing people down. By 10 a.m., federal health officials deployed a new queue system that stalls new visitors on a waiting page so that those further along in the process can finish their application with fewer problems.

About 750,000 had visited the site by Monday night -- about double the traffic for a typical Monday, according to figures from the Centers for Medicare and Medicaid Services.

Roberta Vann, a certified application counselor at the Hamilton Health Center, in Harrisburg, Pennsylvania, said the site worked well for her Monday morning but she became frustrated later when the site went down.

"You can get to a point, but it does not allow you to select any plans, you can't get eligibility (information). It stops there," she said. "The thought of it working as well as it was didn't last long."

In South Florida, John Foley and his team of navigators were only able to successfully enroll one of a handful of return applicants who came to their office before glitches started, including wonky estimates for subsidy eligibility. He worried about how they would fare with the roughly 50 other appointments scheduled later in the week.

Although frustrated, most were not deterred, he said.

"These are people that have policies going away, who have health problems. These are people that are going to be very persistent," said Foley, an attorney and certified counselor for Legal Aid Society of Palm Beach County.

Despite the Obama administration's team of technicians working around the clock, it's not clear if the site will be able to handle the surge of applicants expected by the Dec. 23 deadline to enroll for coverage starting at the beginning of the year. Many navigators also say they're concerned the bad publicity plaguing the troubled website will prevent people from giving the system another try.

"There's a trust level that we feel like we broke with them. We told them we were here to help them and we can't help them," said Valerie Spencer, an enrollment counselor at Sarah Bush Lincoln Center, a small regional hospital in the central Illinois city of Mattoon.

Federal health officials acknowledged the website is still a work in progress. They've also acknowledged the importance of fixing back-end problems as insurers struggle to process applications because of incomplete or inaccurate data. Even when consumers think they've gone through the whole process, their information may not get to the insurer without problems.

"We do know that things are not perfect with the site. We will continue to make improvements and upgrades," said Julie Bataille, communications director for the Centers for Medicare and Medicaid Services.

In less than an hour Monday, Starla Redmon, 58, of Paris, Ill., was able to successfully get into a health plan with help from an enrollment counselor. Redmon, who juggles two part-time jobs and has been uninsured for four years, said she was surprised the website worked so well after hearing reports about its problems.

"Everything she typed in, it went through," said Redmon, who chose a bronze plan and will pay about $75 a month after a tax credit. "It was the cheapest plan I could go with."