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3 PPACA open enrollment surprises

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Gallup conducted a poll from Nov. 6 and Nov. 9 and found that Americans generally had a low opinion of the Patient Protection and Affordable Care Act (PPACA).

Only 37 percent of the 828 U.S. adults they polled said they approve of PPACA, and even the approval rate among adults who identified themselves as Democrats fell to 74 percent, from a 79 percent in June.

Then the PPACA public exchange system opened for business on Saturday, and the consumers poured in through the digital doors. About 500,000 people logged on to, the enrollment site for the exchanges run by the U.S. Department of Health and Human Services (HHS). HHS reports that consumers have placed 100,000 calls to its call center and submitted 100,000 applications for new coverage.

The second annual PPACA exchange open enrollment period is supposed to extend until Feb. 15.

The application deadline for coverage that takes effect Jan. 1 is Dec. 15.

Some health agents and brokers want to become more like the agents who sell auto insurance, and learn to profit from making a little money per customer from helping them enroll in a government-mandated product — and, eventually, from selling them other products.

Other producers view exchange marketing and promotion as an indirect, government-backed marketing campaign for their own efforts to sell off-exchange products.

Still others loathe PPACA and are watching the system in hopes of seeing signs that the system will go away.

So far, what has been surprising about the open enrollment period? To see our thoughts, read on.

Hungry birds

1.  Demand was enormous.

There were some signs that PPACA exchange demand could be weaker. Some state-based exchange managers talked less about marketing plans, and some talked about having less money to spend on marketing this year. became famous for glitches during the first open enrollment period, and news organizations have carried many reports about consumers who are frustrated with high prices for unsubsidized QHP coverage, narrow provider networks, and high out-of-pocket costs.

The new Gallup survey results reflected widespread hostility PPACA.

But it turned out that many people are still hungry for health insurance. HHS says it received a total of about 1 million visitors over the weekend.

The state-based exchanges were also busy. In Idaho, officials at that state’s new state-based exchange, said they had received about 13,000 unique visitors and 700 service center calls over the weekend.

Managers of Maryland’s had severe technical problems when the first PPACA open enrollment period started. This year, they have already received 500 complete applications.

Minnesota’s MNsure exchange took 3,943 service center calls, and Massachusetts’ HealthConnector said Saturday that it had gotten 1,704 people to select QHPs on the first day.

Charles Gaba, the editor of the blog, says he believes exchange plan issuers have received confirmed enrollments for qualified health plan coverage for 4,562 people and have received QHP payments for $4,015 enrollees.

2. The exchange systems generally seemed to work reasonably well.

Wayne Sakamoto, a Florida agent, announced proudly Saturday that he had submitted his first application at 6:30 EST and had no problems.

Many consumers also went online to see that the exchange they had used worked quickly and smoothly. 

Provider directory glitch

3. Once the deadlines about how well the exchange enrollment systems worked appeared, people realized that they didn’t work that well.

The Washingtonhealthplanfinder — an exchange that had a functional enrollment website last year — suffered from glitches and had to wait until today to get its site working normally. The hiatus may have given a private health insurance cyber mimic marketing site,, a chance to generate some more leads.

Covered California has had system-disrupting glitches at various points. At press time, its application front page offered greetings in many languages — and a message telling consumers, “Apply To Get Cove red.”

In some cases, “enrollment site problems” could be the result of actions by the insurers. In Nevada, for example, a CO-OP plan had problems with a direct enrollment site URL. In New Jersey, using one insurer’s provider directory led to an error message page.

Some consumers were reporting on Twitter that they are still having trouble proving their identities and logging in.


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