WASHINGTON - The official deadline arrived Monday for Americans to sign up through the new federal health-insurance exchange for health plans that begin Jan. 1. But, without any public announcement, President Barack Obama’s administration officials changed the rules so that people will have an extra day to enroll, according to two individuals with knowledge of the switch.
Over the weekend, government officials and outside information-technology contractors working on the online marketplace’s computer system made a software change that automatically gives people in the 36 states, including Arkansas, served by the federal site a Jan. 1 start date for their coverage as long as they enroll by 10:59 p.m. CST on Christmas Eve. Some of the states running their own insurance exchanges also have extended their deadlines.
The switch is the most recent rule change - some by government officials, and at least one by the insurance industry - as a milestone approaches for what has been a tumultuous three-month start of the opportunity for Americans to buy new health plans under a 2010 law intended to reshape the nation’s health-care system.
For the first two months of the sign-up, a federal website, healthcare.gov, had so many software and hardware defects that many consumers who wanted to select insurance were frustrated by error messages. And administration officials held off on a planned campaign to urge people to take advantage of the opportunity for new insurance.
At the start of this month, Obama administration officials announced that the website was largely working smoothly and began tourge consumers to sign up for coverage before Monday’s deadline. The full open-enrollment period extends through the end of March, but the first deadline is for people who want coverage to start on New Year’s Day - the date it becomes available.
One individual familiar with the unannounced extension said that it is, in part, intended as a buffer in case the website has trouble if a last-minute surge of insurance seekers proved more than the computer system could handle.
According to the two individuals, both of whom spoke on condition of anonymity about a matter that is not public, the one-day extension is automatic, built into the software, and cannot be overridden by individual insurers if they object.
Asked to explain the reason for the extension - and why it was kept secret - officials at the Centers for Medicare and Medicaid Services, the federal agency overseeing the health exchange at first declined to respond. By early afternoon, Julie Bataille, director of the centers’s office of communication, said that the official deadline for signing up for Jan. 1 coverage remained Monday, but she added: “Anticipating high demand and the fact that consumers may be enrolling from multiple time zones, we have taken steps to make sure that those who select a plan through tomorrow will get coverage for Jan 1.”
An administration official, speaking on condition of anonymity, said that computer systems had been programmed to accept consumers who try to enroll through Dec. 24, “proactively recognizing that we need to be prepared to handle heavy online traffic or other technical issues.”
People calling the federal exchange Monday morning were greeted with a recorded message that said: “Welcome to the health insurance marketplace. We are currently experiencing longer-than-normal hold time. Do you need coverage for Jan. 1? Please stay on the line, as your call is important to us.”
The government told callers to be prepared for a long wait. “If you are using a cell or cordless phone, make sure it’s fully charged,” the message said.
By Monday afternoon, the site had received a record 850,000 visits, five times the number logged by the same time last Monday, the administration said. Bataille said the system was handling the volume with error rates of less than 1 in 200 and response times of less than one second. CHANGE DRAWS CRITICISM
In recent days, insurance industry leaders have protested other eleventh-hour rule changes by the administration. They include a decision late last week by the Department of Health and Human Services to offer an exemption from a requirement that most Americans have insurance as of Jan. 1. The exemption applies to people whose health plans are being canceled because the policies failed to meet new federal benefits standards.
On Monday morning, one insurance industry official, informed by The Washington Post about the quiet deadline extension, criticized the move. “Making yet another last-minute change to the rules by shortening an already-tight time period in which to process enrollments makes it even harder to ensure people who have selected a plan are able to have their coverage begin in January,” said the official, who spoke on the condition of anonymity because the change has not been made public.
In Ohio, Lt. Gov. Mary Taylor called the deadline extension “a clear sign healthcare.gov continues to struggle.”
“Consumers are already confused and insurers are overwhelmed with the administration’s last-minute changes, yet there seems to be no end in sight,” said Taylor, a Republican who heads Ohio’s Insurance Department.
The government’s original deadline already had been pushed back a week because of the website problems. The extra day will add to the already daunting administrative problems that insurance companies face, such as inaccuracies on applications, said industry consultant Robert Laszewski.
“Insurers would like to have two to three weeks to process applications. Now they’re going to have a week, less one more day,” he said. “When the day is done, it doesn’t help.”
Health and Human Services Department Secretary Kathleen Sebelius this month asked insurers participating in the federal marketplace togrant several kinds of flexibility to customers - including allowing them to sign up for health plans in January and make the coverage retroactive to New Year’s Day. Many insurers have refused to go along. But the insurance industry’s main trade group, America’s Health Insurance Plans, last week made its own policy change, saying that anyone who signed up by Dec. 23 would be given until Jan. 10 to pay their first month’s insurance premium.
During December, enrollment through the federal marketplace has increased significantly from a meager start during the first two months - but it still lags behind the Obama administration’s expectations. As of Sunday, the total enrollment through the federal marketplace was roughly 890,000, according to government figures that have not been made public. That compares with about 137,000 who had signed up by the end of November, and about 227,000 more who had signed up by then through the 14 state-run marketplaces.
In contrast, a Sept. 5 Health and Human Services Department memo, obtained this fall by The Associated Press, projected that the enrollment nationally would hit 3.3 million by the end of December.
Beyond the unannounced extension through Christmas Eve, senior administration officials have pointed out during the past two weeks that rules under the law allow a “special enrollment period” for customers who tried and failed to meet the regular deadline.
One official, who asked not to be identified to discuss ongoing operations, told reporters Thursday that health officials “are working through that guidance right now in terms of how that would work for consumers, so that all those who make a goodfaith effort to get enrolled by the deadline will get the effort for them to get covered and get it right.”
MORE CALL CENTER STAFF
The administration also has hired an additional 800 people to handle calls from consumers seeking to enroll on the federal exchange, bringing the total number of call center staff to 12,000 in 17 sites across the country.
As the deadline drew near Monday, more than 1 million people visited the website over the weekend, and a federal call center received more than 200,000 calls.
Roger Colyn, 60, of Des Moines, Iowa, was happy when he left his Monday morning appointment with a state enrollment navigator. She helped him sign up for a “silver” plan that will cost him $10.79 in monthly premiums after government aid is factored in.
“I feel relieved,” Colyn said.
Others said they will let the date pass without making a decision.
“I’m in no hurry, though it’d be nice to be able to visit a doctor without stress,” said Kyle Eichenberger, an uninsured 34-year-old from Oak Park, Ill., who said he hit a wall on the website when he first tried to enroll early on.
“I’m an Obamacare supporter, though I think it is full of problems,” Eichenberger said. “I’d like to see the whole system streamlined to be more user-friendly. Keep the basic idea, but don’t make me feel like I’m navigating a maze to get a simple checkup.”
Minnesota, one of the states running their own insurance exchanges, extended its Monday deadline to Dec. 31 amid problems with its website and extra-long hold times to reach its help center. Maryland pushed back its cutoff date to Dec. 27. New York extended its deadline to midnight Tuesday.
Nevada stuck to its Monday deadline, and enrollment counselors there reported a surge of interest.
“We have people lined up out our door. We still have walk-ins, people are asking for help. Our phones are ringing nonstop,” said Andres Ramirez in Las Vegas.
In Connecticut, which also kept to a Monday deadline, Ronshelle McIntyre, a 41-year-old mother from New Britain, arrived at a state-run insurance store around 9:30 a.m., and by noontime, she was among about 40 people waiting to speak with a specialist. Some were told the wait could be two hours or more.
“I don’t mind,” said the mother of three. “For health insurance, I think all it’s going to cost me is a little bit of time and patience to get it plugged up, you know?” OBAMA SIGNS UP FOR COVERAGE
Also on Monday, the White House announced Obama’s enrollment for health coverage through the new insurance exchanges, calling it a symbolic show of Obama’s support for the fledgling exchanges. Ironically, it also served as a reminder of just how complex and sometimes daunting the process can be.
Obama, like so many other Americans, couldn’t use the website.
“The complicated nature of the president’s case required an in-person sign-up,” the White House said.
White House officials noted that for security reasons, the president’s personal information is not readily available in government databases that the exchanges use to verify identities and check eligibility for tax subsidies.
The White House said that, sometime over the weekend, aides had enrolled Obama through an in-person enrollment site while the president was vacationing in Hawaii.
As commander in chief, the president receives his health care through the military, so his new coverage will go unused. Obama selected a bronze plan, the least-expensive plan available for someone his age, 52. The White House said the plan Obama chose will cost him less than $400 a month. The president’s wife and daughters, who already have health care, did not enroll.
Information for this article was contributed by Amy Goldstein and Juliet Eilperin of The Washington Post; by Carla K. Johnson, Josh Lederman, Sandra Chereb, Susan Haigh, Catherine Lucey, Kelli Kennedy, Patrick Condon, Brian Witte, Michael Virtanen, Ann Sanner and Donna Blankinship of The Associated Press.
Front Section, Pages 1 on 12/24/2013