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A View Of Insurance Marketplace Problems From 4 States

As snafus with the federal health insurance website have multiplied, some states are making halting progress getting people signed up for coverage. But the picture isn't pretty.

Mississippi and Alaska are depending on the federal government for their sites, and they haven't managed to sign up many people. California and Oregon built their own exchanges, but even those sites are having problems. Here is a roundup from NPR member stations in those four states.

Alaska averaged one sign-up a day last week on the state's new Affordable Care Act marketplace, where it was taking up to three hours to successfully enroll an individual in a health insurance plan. "It overall is very challenging. It's definitely not functioning at the level we need it to function," said Tyann Boling, chief operating officer of Enroll Alaska. "You know we're trying to enroll much more people than we're actually able to enroll," she said. "But the problem is, sometimes it works and the majority of the time it doesn't." -- Annie Feidt, APRN, Anchorage, Alaska

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When enrollment opened Oct. 1 in California, a tool designed to help consumers search for doctors wasn't working. Early last week, Covered California officials said the search tool was up and running. But, within hours, those using it found a slew of problems. Covered California, which runs the state exchange, took it offline again to make some fixes. "I had an opthamologist friend listed as speaking Farsi, Russian and Spanish, and he doesn't speak any of those languages," says Dr. Richard Thorp, president of the California Medical Association, which represents about 37,000 doctors statewide. Perhaps even more awkward, data loaded into the site contained errors that linked doctors to the wrong specialty. For instance, Thorp says, a gynecologist friend of his was listed as an ophthalmologist. -- Stephanie O'Neill, KPCC, Southern California Public Radio, Los Angeles

While Mississippi's federally run exchange is improving, mountains of problems have prevented many uninsured Mississippians from enrolling. Dr. Michael Minor, who is running one of two navigator programs to enroll Mississippians, says most people he has heard from are willing to push through. "We have people that, before it got better, were getting up in the middle of the night just to try and log on because they want coverage. I am sure that there are some people that are a little bit frustrated, but the feedback we are getting from the field, people are going to persevere because they want the insurance," Minor said. Minor says he is not frustrated yet, but that could change if the website is not fully functional by mid-November when outreach efforts hit high gear. -- Jeffrey Hess, Mississippi Public Broadcasting, Jackson, Miss.

Oregon's new health insurance exchange may not be able to start processing applications on its new website until early next month. CoverOregon chief Rocky King said the backup plan is to start processing applications by hand. "I believe we'll be up and running way in time for people to get coverage by Dec. 15th," he said. "That said, we also have contingency plans that we've put in place that we'll be able to accept paper applications and paper enrollment. And we're starting that process this week." -- Kristian Foden-Vencil, Oregon Public Broadcasting, Portland, Ore.

These stories are part of a collaboration among NPR, local member stations and Kaiser Health News.

Copyright 2013 NPR. To see more, visit www.npr.org.