As last-minute sign-ups poured in, the director of Rhode Island’s state-run insurance marketplace on Monday called it a national leader in its efforts to implement the federal health care overhaul, with some states even looking to HealthSource RI for help.
Director Christine Ferguson said at midday that just over 26,000 individuals had signed up for private-plan coverage through HealthSource RI, with most having paid the first month’s premium.
While HealthSource has not released a specific enrollment goal for the period, that’s more than double the unofficial federal target of 12,000 by March 31.
“We really are the envy of the rest of the country and the federal government,” Ferguson said. “People should embrace that — but we still need our feet to be held to the fire. We’re holding our own feet to the fire to make sure we keep this up.”
In Connecticut, officials said the state’s health insurance marketplace experienced a surge in last-minute enrollees and was on track to sign up about 200,000 people in health plans by the enrollment deadline, double the original goal of 100,000.
As of Sunday night, 191,961 people had signed up for coverage, with 74,000 in private health plans and the rest in government-funded Medicaid plans, said Kevin Counihan, CEO of Access Health CT. Counihan said the exchange had been “swamped” on Monday. It’s unclear how many of the enrollees were previously uninsured. An analysis is expected this summer.
Monday was the final day of the first open enrollment period; another will be held this fall. Small business and Medicaid sign-ups will continue on a rolling basis. As of March 8, Rhode Island health officials had reported 48,602 Medicaid enrollments, well above the number expected by that point.
The marketplace was experiencing what officials described as exceptionally high call volumes and walk-in traffic ahead of the 11:59 p.m. deadline. People unable to complete enrollment in time because of a “system issue” may be eligible for an extension to avoid the Affordable Care Act’s fine for being uninsured.
In an interview, Ferguson said the Rhode Island marketplace has outperformed most other state-run exchanges on several measures, including how many of those eligible for federal subsidies have enrolled and per-capita small-business enrollment.
Implementation of the federal health care law has been plagued with problems in states including Maryland, Massachusetts, Oregon and Vermont. The federal government’s healthcare.gov website, used by states that did not build their own marketplace, has also had many technical problems.
Ferguson said she was pleased with Rhode Island’s results, but was not complacent.
“I am satisfied with where we are given all of the barriers, challenges and opportunities we had. Am I satisfied that this is it? No,” she said. “There are plenty of places where the processes can be improved and the focus on affordability and small business needs to be much higher.”
Rhode Island has offered guidance to several states, including Oregon and Virginia, and to the federal government, and more such conversations are planned, according to Ferguson.
One issue that’s far from settled is how Rhode Island’s marketplace will be paid for once federal funding dries up. Ferguson has told lawmakers that HealthSource will be allowed to stretch its use of federal dollars through all of next year, even though the assistance was supposed to expire at the end of 2014.
Legislators have been questioning the best way to finance it, and whether the state can afford its estimated annual price of $23.9 million.
Ferguson said she saw the marketplace as part of the effort to stop skyrocketing health care costs. “None of the ways that we have tried to address it to now has got us very far,” she said. “This is a new kind of approach and model to put into the equation. I think it’s a healthy, good conversation for the state to be having.”
Gov. Dannel P. Malloy acknowledged that the large enrollment numbers in Connecticut came as somewhat of a surprise.
“I don’t think any of us thought, in our wildest dreams, we would be as successful as we are about to be,” he said.
Given the state’s apparent success, Malloy said that Connecticut is ready to partner with other states interested in using Access Health CT’s technology.
About 100 people were packed inside Access Health CT’s New Britain store on Monday afternoon waiting for enrollment help. Christopher Colon, 52, of New Britain, admitted he should have signed up sooner, thinking Congress might delay the deadline. “I procrastinated. I waited too long,” said Colon, a 53-year-old machinist. “It’s just like Christmas. Everybody is procrastinating when it comes to shopping. This time it’s insurance.”
Colon was given ticket No. 83 and told he might have to wait three hours to meet with an enrollment worker. But he took the long wait in stride as he sat with a line of people on a bench.
“It’s just something that you basically need,” he said, adding that he hasn’t had coverage for two decades and was lucky “to be one of those people who don’t get sick.”
The staff at the New Britain storefront estimated they had enrolled at least 200 people by late afternoon. They planned to stay until all customers were served.
Robert Strucks, of Newington, said it took him four hours to finally get enrolled. A seasonal employee with a lawn care business, Strucks said he tried to sign up for coverage online but the website was too slow.
Counihan said Access Health CT’s website traffic was extraordinary on Monday. During the first deadline for coverage, Dec. 23, 2013, there was an average of 833 people visiting the website at a time. On Monday at the Access Health CT’s headquarters, a computer screen that tracked the web traffic often reached 1,300 visitors or more.
Additionally, Access Health CT was affected by the federal website shutting down Monday for several hours. Counihan said that affected the ability of the staff to verify enrollee’s eligibility for tax credits.
Despite Monday’s wait, Strucks said he was pleased with the coverage he finally got, even though it doesn’t start until May 1.
“I feel comfortable now, more than I did without it,” he said.