DENVER – Donna Smith is fighting cancer, and she wishes she didn’t have to fight the state, too.
The Denver resident shared her complaint Monday with directors of the Colorado Health Benefits Exchange, the new website that is a crucial part of the Affordable Care Act championed by President Barack Obama.
Smith’s story highlights one of the main early problems with the exchange. In order for people to get tax credits to buy a private policy, they have to leave the website and apply for Medicaid – even people such as Smith, who’s pretty certain she makes too much money to qualify for government insurance for the poor.
“I’m sitting on Day 36 right now of my application,” Smith said.
She would like to ditch the “lousy” $875 a month policy she has now, and she wants the exchange to work, but she’s nervous about the length of time it’s taking.
“I can’t be without coverage on Jan. 1. This is a very real human issue,” Smith said. “It’s very painful. It’s very stressful, and it needs to be solved.”
The exchange launched Oct. 1, but just 3,408 people bought private insurance policies through the website, connectforhealthco.com, during October. Ten times as many, 34,168, signed up for Medicaid last month.
At the same time, insurance companies said they were cancelling the policies of 250,000 Coloradans, often because they don’t meet the minimum requirements of the Affordable Care Act. Those people have until Dec. 15 to get a policy in place by New Year’s Day.
Several directors of the Colorado Health Benefits Exchange said at Monday’s board meeting they were nervous – not so much about low-enrollment numbers so far, but of a stampede to meet the Dec. 15 deadline.
They admit their application process is clunky because people who want a tax credit for buying on the exchange have to leave the website and apply for Medicaid first. Once they’re denied, they can come back and possibly get a subsidy to buy a private policy.
But the exchange loses customers when they have to leave the site so the state can see if they qualify for Medicaid, said Patty Fontneau, CEO of the exchange.
Sue Birch, director of the state’s Medicaid agency, said the backlog is shrinking every day, and 80 percent of applicants get an answer within two days, or often instantly.
Steve ErkenBrack, an exchange director and vice president of Rocky Mountain Health Plans, pressed Birch to move even faster. He’s worried about a rush on Dec. 15 to secure insurance policies.
“(What if) you have 100,000 Coloradans who have four hours to buy coverage, and the system crashes?” ErkenBrack said. “This is a huge issue.”
The board of directors didn’t make any changes Monday, but they heard short-term and long-term strategies to make the application process run smoother.
In the long run, the Colorado Health Benefits Exchange and the state government are planning to create a single application for both Medicaid and private insurance. But that won’t be in place until next October, when enrollment for 2015 insurance policies begins, Fontneau said.
More than 700,000 Coloradans lack health insurance, and directors of the exchange have a goal of getting 136,000 of them onto the insurance rolls, either through a private policy or Medicaid, in the next year.
jhanel@durangoherald.com
