Miami-Dade County improved, but South Florida users still stymied

Long waits, error messages, unresponsiveness.

Hallmarks of the troubled launch of the Health Insurance Marketplace at continued to stymie South Florida residents and counselors trying to access the website on Monday — more than two months after the Oct. 1 launch, and despite the government’s self-imposed deadline of Nov. 30 for the system to function smoothly for the “vast majority of Americans.’’

At Borinquen Medical Center, a community clinic with seven locations in Miami-Dade County, counselors turned away consumers Monday morning because they could not access, said Jason Conner, who manages Borinquen’s enrollment team of 10 full-time counselors.

“We’ve seen steady improvements over the last two weeks,’’ Conner said Monday afternoon. “Today, however, seems to be an anomaly to those two weeks, and we’re not able to enter the system at all.... It was working better last week than today.’’

With less than three weeks until the Dec. 23 deadline for individuals to purchase policies that take effect on Jan. 1, Obama administration officials said on Monday that has vastly improved but conceded that the website still may not be able to handle the crush of people expected to seek insurance this month.

A cornerstone of the Affordable Care Act and the vehicle through which millions of uninsured Americans are expected to gain coverage, serves 36 states, including Florida. Fourteen states and the District of Columbia manage their own state-based online marketplaces, or exchanges, which also have experienced technical problems but enrolled more people in October than the federal site, according to the Department of Health and Human Services.

Federal officials said Monday that the site’s functionality has greatly improved since launch, and that more Americans are enrolling every day. But they cautioned that problems will persist — particularly during periods of high demand, said Julie Bataille, communications director for the Centers for Medicare and Medicaid Services, the agency that administers

Bataille said the website had hosted 375,000 unique visitors between midnight and noon Monday. “That’s roughly twice the size of what we had been seeing on a typical Monday,’’ she said, noting that website usage peaks from 10 a.m. to 3 p.m. on weekdays but slows down during early mornings, evenings and weekends.

In fact, Bataille said, website visits on Monday reached a point where federal officials deployed a new customer queuing system for the first time.

The queuing system gives consumers the option of waiting in line with a timer appearing on their screen, or leaving the website and waiting to receive an email notifying them of the best time to return and resume their applications.

Bataille said the technical team working to repair also made significant progress in another area: so-called 834 forms, which transmit consumers’ enrollment information to insurers. Without that data, insurers cannot be certain who has enrolled in their plans, and consumers cannot be assured that they are covered.

Those forms had been riddled with errors, according to previous reports, but Bataille said on Monday that “most of those fixes that were needed have been addressed.’’

She said the technical team working to repair determined that “more than 80 percent’’ of the 834 form errors were due to a bug that prevented Social Security numbers from transmitting correctly.

About two weeks ago federal officials announced a pilot program allowing consumers to enroll directly through insurance companies, and to bypass entirely. Bataille said that pilot program has shown signs of success in the test states of Florida, Ohio and Texas.

Under the direct enrollment system, insurers estimate what they are owed rather than have calculate the bill. The government then sends the insurance companies the federal subsidies used to help eligible Americans buy coverage.

Bataille said Florida Blue, the state’s largest health insurer, planned to expand direct enrollment from “a few agents” to the insurer’s entire network. However, Florida Blue officials said they could not confirm that information as of Monday night.

Federal officials also added new features to, including a “reset” option for individuals who had created accounts before Nov. 30 but had trouble using those accounts to access their information or the website.

Another new feature gives consumers more detailed information on available plans by state and county — including monthly premiums, deductibles and provider networks, Bataille said.

The new feature will help consumers shop and compare plans. But when it comes time to make a purchase through, the experience may feel like a crap shoot.

At Borinquen, the process ground to a halt on Monday morning and then eased up later in the afternoon. Conner, the enrollment manager, said counselors managed to help three consumers through the process — out of the 40 seeking their help on Monday.

Ditto for the Doral-based Epilepsy Foundation of Florida, which received a $637,000 grant from the federal government this year to hire so-called “navigators” who help individuals enroll for coverage.

“It’s been tough today,’’ said Franco Ripple, a foundation spokesman. “Our navigators have been telling us that it’s kind of glitchy.’’

William Warren, an independent insurance agent in Miami Beach, said it took him 45 minutes to one hour during the Thanksgiving weekend to create an account and fill out an application for coverage through

Warren said he has a backlog of clients waiting to enroll, and he’s concerned about the time it will take to complete the process given the Dec. 23 deadline for plans to take effect on Jan. 1. Consumers have until March 31 to sign up for coverage and satisfy the law’s coverage requirements.

“It wasn’t slow in terms of the interface,’’ Warren said of his experience. “It was just time-consuming to read the information on every page. ... This is going to be a challenge to sit with each client through the enrollment process.’’

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.