Overall, 17% of Americans who are potentially eligible for coverage have visited the new health insurance marketplaces to buy coverage via e-mail, Internet, phone or in person, according to the research. Of those who visited a marketplace, 34% went to a state-run marketplace, and 66% visited the federally operated marketplace. Therefore, it can be inferred that the majority of those who had technical difficulties with the exchanges went to HealthCare.gov, said Sara Collins, VP of the healthcare coverage and access program at the Commonwealth Fund, a Boston-based research and advocacy organization.
The data doesn't show whether a lower percentage of people who went to the state-run sites than of those who visited healthcare.gov had trouble enrolling in a health plan, Collins said in an interview. However, she added, "Some states have had fewer [technical] problems, and more people have been able to enroll in states like Kentucky, Washington and California. So they likely had better experiences and were better able to enroll in plans than those who visited the federal sites."
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Although the Department of Health and Human Services (HHS) has not yet released initial enrollment figures for HealthCare.gov, enrollment is off to a strong start in some states. Nearly 174,000 New Yorkers have applied for insurance, and 37,000 have been enrolled. Covered California started nearly 180,000 applications in its first month. And Washington State's insurance website had enrolled almost 49,000 people through Oct. 28.
In the Commonwealth Fund survey, more than half of adults who visited the insurance marketplaces said they found it impossible or difficult to find a plan with the type of coverage they needed or compare the plans on benefits and costs. In contrast, 38% of respondents said it was easy to find a plan with the coverage they desired.
Collins cautioned against reading too much into these findings. The major issue in the first month of ACA enrollment, she said, was the imperfect operations of the exchange sites. So the difficulty in comparing plans was likely related to these technical difficulties.
"On the affordability issue, people probably had difficulty finding out if they were eligible for subsidies," she added.
One other obstacle to using the exchange sites, she noted, are the impediments that some states have thrown up to the outreach counselors, also known as "navigators," who are supposed to help individuals understand their insurance choices and enroll in plans. Ohio, Missouri and Georgia require navigators to get licenses, and "17 states have passed legislation to restrict what they can do," Collins said.
Regarding language barriers, she noted that all of the exchange sites are legally required to provide instructions in both English and Spanish. However, she couldn't say whether all of them did.