Insurance marketplace, despite inital bumps outlook is positive

Head to Healthcare.gov, the brand new federal insurance marketplace working in accordance with the Patient Protection and Affordable Care Act, and you’ll find photos of smiling faces, a countdown of days until enrollment ends and a large green button marked “Apply Now.” But travel much further and you may run into some glitches and trouble, according to numerous news sites – and even the President himself.

But, despite the inevitable bumps along the way, most sources are positive on the outlook for the new marketplace, which will bring services and care to the uninsured and mentally ill around the country in need of coordinated care systems.

Debuted amid turmoil

The ACA had a rocky start from the very beginning of its life. Disputed in Congress, ratified by the Supreme Court after numerous allegations of unconstitutionality, pledged to be rescinded by 2012 Republican presidential candidate Mitt Romney and – finally – a major point of contention in Congress before the government shutdown – the ACA has had a tumultuous existence, both as a bill and a law. And one of its most-contended features, the health care marketplace, launched online just hours before the shutdown took effect on Oct. 1, 2013.

The president spoke in the White House Rose Garden Oct. 1 to mark the inauguration of the marketplace, reported NBC News. He said that despite the temporary closure of the federal government, a large part of the ACA is running full steam ahead.

“Today Americans who have been forced to go without insurance can now visit Healthcare.gov and enroll in affordable new plans that offer quality coverage. That starts today,” he said.

In response to criticism that the marketplace has been buggy and sluggish, the president acknowledged that, as with every new law or product rollout, there will be inevitable glitches that the government will fix. According to the president, part of what has slowed down the site during its initial launch has been traffic. He noted that the more than 1 million people who visited the site before 7 a.m. on Oct. 1 was five times more than the number of individuals who had ever logged onto Medicare.gov.

The president compared the marketplace debut to Apple’s recent iOS7, which featured a few first-day glitches that the company then remedied.

“I don’t remember anybody suggesting Apple should stop selling iPhones or iPads – or threatening to shut down the company if they didn’t. That’s not we do things in America. We don’t actually root for failure.”

Persistent problems

On Wednesday, Oct. 2, The Los Angeles Times reported that website glitches at Healthcare.gov, which is the central portal for citizens in 36 states, continued to prevent some consumers from enrolling. According to the news source, the health care websites of the remaining 14 states – including California, Connecticut, Washington D.C. and Maryland, among others – are also struggling to meet demand. Call-center hold times for the California site were reported more than half an hour on Wednesday.

But, in a sense, all the traffic is a good thing. According to the U.S. Department of Health and Human Services, as cited by The Los Angeles Times, in its first 36 hours, the new federal website brought in 6.1 million unique visits.

What is the demand?

Citing U.S. Census Bureau stats from 2012, The New York Times recently reported that approximately 15.4 percent of Americans are estimated to be uninsured. That’s about 48 million people – or about 42 million more than visited Healthcare.gov during its first 36 hours.

And, according to The Times, another grim reality is setting in. Even amidst the “sweeping national effort” to improve health care coverage in America, millions will be left out.

The Times reported that according to its analysis of census data, the coverage “will leave out two-thirds of the poor blacks and single mothers and more than half of the low-wage workers who do not have insurance, the very kinds of people that the program was intended to help …”

Many of these individuals live in states with G.O.P. governors, who have declined to expand Medicaid – a medical insurance program for the poor, which uses the poverty line as a strict demarcation for application. As a result, these 8 million Americans are “impoverished, uninsured and ineligible for help,” noted The Times.

These individuals, some of whom are dealing with mental illness, will be stuck in between the tier of workers with slightly higher incomes who qualify for the new exchange and those who are poor enough to qualify for Medicaid.

Clearly, there are glitches and discrepancies in the system which call centers and HHS tech teams cannot hope to iron out. But the potential of the new marketplace is strong. Among the advances in the field of mental health care – from behavioral health software to coordinated care platforms tied through secure health information exchanges – the marketplace may yet prove to be the most important. The next goal is to widen its reach.