One Day on the Exchange

By Scott Hultstrand, SCMA General Counsel

After 24 hours of trying to sign-on, the new Health Insurance Exchange has proved elusive for me thus far.  We all have heard about the glitches and the problems with the Exchange, but I wanted to see for myself what a consumer experience on the exchange was like for a South Carolinian.  So, yesterday around noon I began the process of logging on to the South Carolina Health Insurance Exchange (or “Marketplace” as the feds have tried to rename it).  It is now almost noon on Thursday and I still have not been able to access the Exchange.  Here’s a brief timeline of events.

Wednesday:

12:30 PM – I did a Google search for the South Carolina Health Insurance Exchange, and nothing came up that was helpful.  So, I went straight to HHS.gov, which is the federal government website for Health and Human Services.  There I was able to click on a link that took me to the Exchange.

12:35 PM – I clicked on the “Apply Now” button but instead of going to a web page that has an application, I am directed to a page that says:  “We have a lot of visitors on the site right now.
Please stay on this page. We're working to make the experience better, and we don’t want you to lose your place in line. We’ll send you to the login page as soon as we can. Thanks for your patience!”  I go on to other work duties as I wait in line to get access to the application.

12:45 PM – I finally get to the application page, which asks me what state I am from and then directs me to a different page to set up my account.  All it takes to set up your account is a user name, a password, and an email address.

12:50 PM – After coming up with my username and password, I click on the button to start my application, but instead I get a message that HHS will be sending me an email to confirm my account.

1:20 PM – It takes 30 minutes to receive the email confirming my account, and when I get the email I click on a link that HHS sent me, which takes me to a page saying that an error has occurred, and my confirmation can’t go through.

1:25 PM – I wait five minutes and then click on the email link again.  This time, it says an error occurred because I have already confirmed my account. 

1:30 PM – I go back to HHS.gov and attempt to log-on.  No luck here, as HHS says I entered the wrong password.  I enter my password ten more times with no results.  I start thinking that even though I just made up my password forty-five minutes ago, that I have forgotten it, so I click on the “Forgot Password” button, which says it will send me an email with directions about how to set a new password.  That email takes over four hours to get to me, not reaching my inbox until 5:52 pm.

1:45 PM – I try one more time to log-on, and this time I am elated, because the URL on the top of the screen has the word “Success” in it.  Unfortunately for me, “success” means a completely white screen with nothing else on it.  No content, no links, just white.  So, I try to log-in again and I get the “wrong password” message again.  At this point, I give up for the time being.

9:30 PM – I try a few more times at home to log-in, but still nothing.

Thursday:

10:00 AM – I try again to log-on, and again the white screen of nothingness.

10:10 AM – Another attempt, and no white screen this time, but now a message stating that a system error has occurred and the page cannot be reached.

So, what does all this mean?  Ultimately, not that much, unless these problems persist.  And, of course, all I am trying to do is log in to the system.  I haven’t even gotten close to giving them my personal information so that the HHS super-computer can churn out what I qualify for and what kind of tax credits may be available (I have to confess being a little nervous about entering in my personal information, but that may be a job hazard I just need to embrace).

If problems like this persist, it is likely that South Carolina won’t have many patients insured in the Exchange for 2014.  This is not unexpected, though, since we have been predicting a slow roll out for many months.  As the kinks get worked out of the system, and they will eventually, we will likely see more and more patients feeling comfortable logging on to the Exchange, especially when tax credits are available for the purchase of coverage.

We have been advising physician offices to be careful when signing Exchange contracts with insurers.  On the one hand, it is likely that the patient population in the Exchange will not be very high, so you won’t have many patients initially who have an Exchange plan.  On the other hand, that could change rapidly depending on what the business community ultimately decides about offering health insurance.  It is not outside the realm of possibility that a huge employee dump onto the Exchange could happen.  In that case, you could get caught in a situation where you have a large number of patients who now have Exchange plans, but you are not in the network.  And in some cases it may be too late to join the network in light of the narrow networks that are being built for Exchange offerings.

In the midst of all this confusion, you can count on the SCMA to be working hard to provide you with the counsel you need to make good decisions about the exchange.  Stay tuned for more updates as the Exchange progresses from mostly glitches to a viable option for patients.