For Some, Health Exchange Is A Breeze. For Others, An Unending Headache

Nov 1, 2013

New hires train to take calls at Washington's health exchange call center in Spokane Valley.
New hires train to take calls at Washington's health exchange call center in Spokane Valley.
Credit Northwest News Network Photo/Jessica Robinson

Washington’s health care exchange got off to a rocky start one month ago Friday: from the temporary shut down on its first day to the recent errors calculating tax credits. Even so, Washington state has fared well compared to the federal Website and even has some fans.

Charles Redell, a freelance writer and barista in Seattle, is among the more than 50,000 Washington residents so far who have enrolled for health plans through the public exchange. Redell said it took him 25 minutes to sign up online – much better, he said, than the stack of papers he would spread out on his dining room table.

“It’s click, compare this, and you get a chart. It just makes sense,” he said.

He said health insurance gives him peace of mind. “I’m a healthy person, no problems, but as I’m getting older – I’ll be 40 in December – it’s more there on my mind,” he said.

But for those with more complicated situations, like immigrants or who are filing for divorce, the process is more complicated.

Jim Adcock, a former Microsoft employee, is married to a German woman with a green card. They have two daughters.

On the Adcock dining room table are stacks of papers documenting his struggle to show proof of eligibility – his wife's green card, his passport, his Social Security card and a notarized letter he wrote to prove he hasn't been incarcerated.   

Recently, he discovered those documents had disappeared from his online account, and he hasn’t been able to get through to the state’s call center to troubleshoot.  

“Obviously I’m very upset,” Adcock said. “And I really don’t know where to go at this point and time.”

"Cram Them In"

Others have given up on trying to sign up online and have turned to snail mail and the phone.

At an industrial park in Spokane Valley, newly hired call center representatives are learning how to greet callers. Managers plan to double staff by mid-December and are looking for another building nearby to house a second call center.

“Just have to cram them in. We have to get them in,” said Don Albright, who manages the state call center.

Albright said they staffed for about 2,000 calls a day, but that they’ve received three times that. They figured calls would last on average 17 minutes, but they’re taking 30 to 40 minutes.

Although Washington’s site has been a breeze compared with the beleaguered federal one, the state system still has to communicate with the federal data hub.

“If the (federal) hub is not up, we can't really complete our applications here," Albright said.

Which is what happened when a radio reporter was visiting the call center. All applications were brought to a halt.

I think people will find out that yes, it's a great program. It's going to help a lot of people that couldn't get coverage before and now they can

Nationally, customer service lines are turning out to be more important to the Affordable Care Act than anticipated. The US Department of Health and Human Services reports that an additional 2,000 customer service reps will be hired for the federal hotline.

For states that rely entirely on the federal website, it feels a bit like a flashback.

“In lieu of that working, we do have to go to that sort of pre-Internet era,” said Alberto Gonzalez, operations project manager for Your Health Idaho. “You have to do this over the phone or send in a paper application, which is reliable but certainly not the most current way of conducting business.”

Gonzalez said Idaho will eventually have its own state-run exchange.

And in Washington, more people are applying using pen and paper. At the call center near Spokane, customer service representative Katie Reis sat by a desk stacked with paper applications. She said it's hard to keep up with the number of forms coming in by snail mail and fax.

“On Saturdays I come in and I train people to do paper applications," Reis said. "We trained seven last weekend, and we're planning on bringing in 50 more – just to do paper applications.”

Many of the applications are from pregnant women who are looking to get coverage for their doctor visits next year.

Reis said that despite the snags, she supports the new health care law.

“I think people will find out that, yes, it's a great program. It's going to help a lot of people that couldn't get coverage before and now they can,” she said.