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Health Exchange Websites Show Improvements, But Still Spotty


This is ALL THINGS CONSIDERED from NPR News. I'm Robert Siegel.


And I'm Audie Cornish.

The federal government is open again. The threat of a federal default is lifted for now. So, naturally, attention is turning back to the rollout of the federal health law, the Affordable Care Act. The big story before we all got distracted was about how the new health exchanges weren't working so well. Well, now it's two weeks later and we thought we'd check in on whether things have improved.

NPR's Julie Rovner, who covers health policy, joins us in the studio. Hey there, Julie.


CORNISH: So before we get to the state of those exchanges, a big part of the shutdown fight was about trying to essentially defund, or delay or change parts of the health law. Did this final bill to reopen the government do any of those things?

ROVNER: No. You know, Republicans started out demanding defunding, then delaying the entire law for a year. Then they tried to repeal or delay just some small parts. In the end, the only thing in the budget bill was a provision requiring the Health and Human Services secretary to certify that people who qualify for help paying premiums, have their incomes verified. That's something they're already doing.

CORNISH: So no change there, but we're just over two weeks into the six month open enrollment period, right, for these health exchanges? How are things going?

ROVNER: I think the short answer is better but still not very good. It's important to differentiate between the federal health exchange, which is running the signups for 36 states, and the 14 states and Washington, D.C. that are running their own exchanges. Some of the state exchanges seem to be doing pretty well. But we're still getting reports of people having trouble getting on, or getting on and having trouble actually enrolling in a plan in the federal exchange and some of those other state health exchanges.

CORNISH: So give us some details here. I mean what are some of the biggest problems people are still seeing?

ROVNER: Well, talking mostly about the federal website here, it's easier to get onto the site than it was, and it's easier to create an account, which was a huge bottleneck at the beginning. They've also created a shortcut where you can browse through available health plans without creating an account. But now, it seems people are having trouble doing things like comparing health plans, finding out if their specific doctors and prescription drugs are covered, things like that.

CORNISH: But we're actually starting to see some numbers trickle out, right? And mostly about how few people are actually signing up for coverage. What do you make of those?

ROVNER: Well, I think it's really important to take all the numbers that are coming out with a really big grain of salt. First of all, nobody expected a lot of people to actually sign up during the first few weeks. That was really expected to be mostly for people to kind of shop and look at their options. Of course having the websites not working really didn't help very much.

I think some of the really big numbers about how many people were visiting the websites might have been inflated, because those were people - a lot of them going back again and again because they couldn't get through or they couldn't get on the website.

But there's also reason to believe that some of the tiny numbers we're seeing, about how few people are actually signing up, could be artificially low because to actually enroll, you have to pay your first month's premium. And since none of these plans actually start until January, you have to be pretty motivated to pay a premium two and a half months before your coverage kicks in. Although it's also not clear at what point people are being counted as being actually enrolled.

CORNISH: And remind us of the deadline here. I mean at what point does this all need to be straightened out?

ROVNER: I think the administration and the states that are having trouble are racing the clock here. Most experts say they really have to get things working by about the middle of November. That's because people have to have the Thanksgiving holiday and the first part of December to get enrolled by December 15th. That's kind of the first real deadline here. That's when you have to signup for coverage if you want your coverage to begin by January 1st. If things really aren't smoothed out a month from now, then it will be a different story.

CORNISH: That's NPR's Julie Rovner. Julie, thank you.

ROVNER: Thank you. Transcript provided by NPR, Copyright NPR.

Over two decades of journalism, Audie Cornish has become a recognized and trusted voice on the airwaves as co-host of NPR's flagship news program, All Things Considered.