For the nearly 2 million Illinois residents without health insurance, Oct. 1 has been hailed as the start of a new era.
That’s the day when they and millions of other Americans have been told they can start signing up for new health insurance plans, many subsidized by the federal government, a key pillar of President Barack Obama’s landmark 2010 health care law.
But with 25 days to go before a massive online registration system is expected to go live, neither the federal nor the state government has finished work on the complex websites most consumers will use to begin the process of comparing and buying health coverage that begins in January as part of the Affordable Care Act.
While state and federal officials insist the systems will be ready on time, concerns are mounting about the fast-approaching deadline and whether an army of so-called navigators will have enough time to get the training they need to usher people through the process of obtaining coverage.
“I don’t have a crystal ball, but Oct. 1 is definitely upon us. A lot of folks — from the states to the feds — are still in preparation, and they wish it was April or May right now, where they’d have far more time to get this thing ready,” said Karen Pollitz, a health policy expert at the Kaiser Family Foundation. “There’s no question the (implementation) has been more back-ended than anticipated at the outset.”
Consumers can take comfort that Oct. 1 is not a hard deadline to buy insurance. For coverage to start on Jan. 1, individuals should focus on signing up no later than Dec. 15, officials said. So even if there are initial issues with the system, as is common with major technology rollouts, there’s time to remedy them.
Questions about the readiness of the enrollment systems come as a massive advertising and outreach effort kicks off in Illinois, where millions of dollars of funding is about to be unleashed to promote enrollment in the online insurance exchanges and the state’s expanding Medicaid program.
Although Illinois and its partner, FleishmanHillard, have yet to roll out a federally funded $35 million publicity campaign, the private group Enroll America plans to launch an effort this weekend through a series of events that aims to raise awareness in Illinois about the coverage.
The Washington, D.C.-based nonprofit is partnering with organizations like Planned Parenthood of Illinois, the Illinois Coalition for Immigrant and Refugee Rights and the Campaign for Better Health Care to target hard-to-reach populations, including minority communities, young people and others.
David Elin, the Illinois state director for Enroll America, said his group has brought on dozens of volunteers who will begin educational and outreach efforts Saturday in the Roseland neighborhood.
He said staff members and volunteers will continue the campaign into the spring, canvassing neighborhoods, going door-to-door, setting up phone banks, attending community meetings and forging partnerships with other community groups. Elin declined to say how much Enroll America plans to spend.
“Illinois is one of just 10 states that we’re in, so our efforts here to get information to (the) uninsured is vital,” Elin said.
Of those without insurance in the state, officials expect about 486,000 to buy a health plan through the online insurance exchange for 2014. Another 200,000 or so are expected to sign up in the first year for coverage under an expansion of the state’s Medicaid program to individuals who earn up to 138 percent of the federal poverty level, or about $15,860.
The state website where the majority of Illinoisans are expected to begin the process of obtaining subsidized health coverage remains “in production,” and state developers “are working very diligently to get it up and running by Oct. 1,” said Mike Claffey, a state spokesman.
That site is essentially a landing page that will direct consumers to a state-based website to apply for Medicaid, the state-federal insurance program for the poor or disabled, or to the online insurance exchange operated by the federal government where Illinois residents can buy health coverage.
Many of them may be eligible for federal tax credits to help defray the cost of buying insurance, depending on household income.
While the portal is not yet ready, “we’re very far along in solving it,” Claffey said.
Illinois also is amid a major overhaul of its integrated eligibility system, which is where individuals can apply for an expanded Medicaid program starting Oct. 1. The state has a team of 50 people testing the system since July to ensure it will be ready once consumers start logging on.
Claffey said the state has a “high degree of confidence” that the system is working.
Because the federal government also has yet to finalize its portion — the exchanges it is building for 34 states, including Illinois — time is running short for officials to ensure the various systems can communicate with each other, a critical factor for the launch.
The Centers for Medicare and Medicaid Services, the federal agency leading the implementation of the health care law, said it remains on track to open the exchanges by the deadline, though officials say final testing of the systems is not complete.
“We are working hard to ready this consumer tool,” the agency said in a statement.
At least one state has said it will delay the launch of its exchange for some individuals because its computer infrastructure will not be ready in time.
Oregon, one of 16 states and the District of Columbia that will develop their own insurance exchanges, will limit marketplace access to residents working with an insurance broker or a state-trained navigator during the first few weeks of October to give it time to sort out technical issues. California also has said it is considering a short delay.
Meanwhile, because neither the state’s nor the federal government’s systems are ready for public consumption, training for the group of paid helpers who will assist individuals in choosing health coverage is incomplete. As part of the health care law, Illinois has received about $31 million in federal funding for community organizations, health departments and nonprofits to hire and train workers to help people sign up for insurance.
Without access to the exchanges or experience working with them, they may find themselves teaching themselves the systems at the same time they’re supposed to be helping consumers navigate them.
Although the University of Illinois at Chicago has trained more than 900 navigators on behalf of the state, “we’re still fairly in the weeds,” said Elizabeth Calhoun, a professor of health policy and administration at UIC who developed the training curriculum and is leading the training effort.
Calhoun and her team at UIC have 11 more scheduled training events in September, and she estimates they’ll be conducting more beyond Oct. 1.
“The good news is, I think we’re going to be much more prepared in Illinois than other states,” Calhoun said. “We’ve been working on this for a long time, and I’ve been incredibly impressed by the group of people coming through.”
Still, she acknowledged, “It’s obviously a rush to get this done, and it would have been easier if we had some of this information (from the federal government) earlier.”
Twitter @peterfrost
