By Chad Terhune and Barbara Feder Ostrov
Covered California, the state’s insurance exchange, announced Friday that it was extending its enrollment deadline until Feb. 6 for people who had officially begun the process of signing up by Sunday.
Exchange officials said they extended the Sunday deadline to accommodate a surge in enrollment in the previous week involving “tens of thousands” of consumers.
As of Jan. 27, the exchange reported that more than 329,000 new consumers had signed up for coverage during the third annual enrollment period, which is within the estimate of the exchange’s estimate of 295,000 to 450,000 new enrollees.
“Will we hit the 450,000?” said Covered California Executive Director Peter V. Lee. in an interview with California Healthline Friday. “I’m not sure. But have we got enough people in and will we continue to get enough renewed to have a very good risk pool? I’m very confident of that.”
“One of the reasons we have talked [enrollment] ranges is because every crystal ball is a cloudy crystal ball,” he said.
Most people who fail to sign up by the deadline face tax penalties of $695 per adult, plus $347.50 per child, up to a maximum of $2,085 for a family, or 2.5 percent of family income in excess of 2015 income tax filing thresholds.
After open enrollment ends, consumers may sign up only if they have a life-changing event such as getting married, having a child or moving. Enrollment in Medi-Cal, the government program for lower income people, is year-round.
With renewals and new enrollees, Covered California appears on track to have about 1.5 million enrollees, but the final tally in the weeks ahead will depend on how many people actually pay their premiums. In addition, the numbers churn as people leave the exchange for employer coverage, Medi-Cal or drop out altogether.
“The arbitrary numbers don’t matter,” Lee said. “What matters is the mix of people involved for the stability of premiums.”
Lee acknowledges that reaching more middle-class consumers who receive less in subsidies remains a challenge. Many consumers say health insurance remains unaffordable, but he said going without coverage is risky.
Lee said the enrollment process had improved significantly with time. “It’s getting smoother with fewer glitches and we are getting smarter each year.”
He cited more outreach in African-American churches and having church leaders talk about Covered California from the pulpit. He noted the shift to micro-targeting of the uninsured by census tracts — akin to a political campaign — and making sure there are insurance agents and storefronts offering enrollment in underserved neighborhoods.
One report to be released Monday suggested, however, that glitches remain in the enrollment process. Researchers from the California Health Care Foundation evaluated 42 consumers’ experiences in trying to enroll in, or renew, their insurance through Covered California’s website. (California Healthline is an editorially independent program of the foundation.)
Though the study sample was small, the researchers found that the consumers struggled to complete their applications online – despite improvements to the site in the past year. None were able to actually do so in the sign-up sessions monitored by researchers – even though some sessions lasted as long as two hours.
“Poorly designed” online forms and unclear questions related to income and household size frustrated users and led to mistakes that kept consumers from completing their applications, the researchers concluded.
Parts of the application process seemed like a bureaucratic nightmare: “New enrollees received multiple error messages because they had not followed the eight requirements for creating a valid password — even though the rules are not provided at the outset of the process.”
For one participant, “it took 10 minutes and seven attempts to create an acceptable password,” the researchers wrote.
Whether or not they faced difficulties, many consumers rushed to sign up as the deadline approached.
In San Jose, Jenna Santiago’s Friday was filled with appointments for people who wanted to sign up before Sunday’s deadline.
“I absolutely have been busier in the last week,” said Santiago, a community health counselor for Catholic Charities of Santa Clara County. Lately, she said she had been seeing five clients a day, rather than the five a week she helped when enrollment started Nov. 1.
Santiago said most of her clients just want to avoid the tax penalty.
“A lot of folks are surprised when they hear the amount,” Santiago said. “They don’t realize it’s going to be that high.”
Some would-be enrollees found themselves out of luck.
On Sunday, Anthony Johnson was disappointed to find that a Covered California kiosk that was supposed to be at the Valley Fair shopping mall in San Jose had disappeared.
He said he had visited a week earlier, but the people at the kiosk, representing an insurance agency, wanted him to come to their office during the week, when he was working.
Johnson, a 53-year-old Gilroy resident, said he had recently had returned with his family after a stint working in the Philippines, and he needed a few months of health insurance to tide his family over until he became eligible for insurance at his new job.
His new employer suggested he check out Covered California. But Johnson said he found it impossible to get through on the toll-free number and that it was too difficult to enroll online. (A reporter who tried the toll-free line Sunday also could not get through to an operator.)
Johnson said was particularly worried because his 13-year-old daughter, who had been exposed to tuberculosis in the Philippines, needed more medicine — at $900 a bottle — to prevent her from developing the active, contagious form of the disease.
“I’m just so frustrated,” said Johnson who added he would look at private insurance alternatives.
Otherwise, he said “I guess we’re going to have to be uninsured until my job’s insurance comes through.”
This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.
Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.