Days before the debut of new online insurance markets, a couple of last-minute technical glitches with President Barack Obama's health care law are making supporters anxious and giving opponents a new line of attack.
The administration said Thursday that small business owners who want to use insurance markets designed especially for them will have to wait until sometime in November before they can finish their sign-ups. They still can start shopping right away on Oct. 1. And even with the delay, they can get coverage for their employees by Jan. 1, when the law takes full effect.
In a potentially more significant delay that affects the law's larger insurance market for individuals, the administration quietly told Hispanic groups on Wednesday that the Spanish-language version of the healthcare.gov website will not be ready to handle online enrollments for a few weeks. An estimated 10 million Latinos are eligible for coverage, and 4 million of them speak Spanish primarily.
“It's been at least two years since we've known that Latinos are a primary target for enrollment through the Affordable Care Act, so we would have hoped that the administration would have the rollout ready on Day 1,” said Jennifer Ng'andu, health care policy director for the National Council of La Raza. That said, she added that her group won't object if it takes a few more weeks to get things right.
Meanwhile, a politically powerful small business lobby that went to the Supreme Court in an unsuccessful bid to overturn the law said the employer enrollment delay strengthens the case for hitting pause on the entire law, one of the strategies now being pursued by congressional Republicans.
“Every step in the implementation process has seen delays and setbacks,” Kevin Kuhlman, a top official of the National Federation of Independent Business, said in a statement. “This is starting to seem like a parody; unfortunately, it is extremely serious.”
New state insurance markets for individuals who don't have coverage on the job, and separate ones for small businesses with up to 100 workers, are a key part of Obama's health care overhaul.
Scheduled to open Oct. 1 — next Tuesday — the markets are supposed to offer a consumer-friendly way to buy health insurance while forcing insurers to compete for business. Consumers can apply online, through a call center, in person, or through the mail.
The markets for individual consumers — called exchanges in some states — will offer tax credits to make premiums more affordable. Tax credits are also available for some businesses, generally smaller firms employing low-wage workers.
Largely because of Republican opposition to the law, the federal government has had to take the lead in setting up markets in 36 states — a development unforeseen when the law was passed. The delays announced this week affect the federal markets, and some states running their own may have full small business enrollment and Spanish-language capabilities.
Gary Cohen, the Health and Human Services department official overseeing the rollout, said small business owners in states with federally-run markets will still be able to go online Oct. 1 and compare their health insurance options. They can get the enrollment process going by filling out a form that will have to be transmitted separately by mail, fax, or as an email attachment. They'll have to wait until sometime in November to finalize their applications.
“We wanted to make sure this was going to work properly and be effective for small businesses,” Cohen said in an interview. “We just felt like taking the additional time to make sure everything was functioning the way we wanted was the right thing to do.”
Under the law, most small businesses do not have to provide coverage. But firms with 50 or more employees face a mandate to offer insurance or risk fines from the government.
That coverage mandate was supposed to take effect Jan. 1, but the administration caused a stir this summer by unexpectedly delaying it a year to address employer complaints.
Delays and pared-back expectations are a standard feature of most big technology rollouts. But the Obama administration has tried to project an image of efficiency and confidence.
Supporters of the law are hoping there won't be any more surprises.
“The electronic system will not be fully operational on Oct. 1, but people will still be able to enroll in coverage,” said Ron Pollack, executive director of Families USA, an advocacy group that backs the law. “Inevitably there will be some glitches. The real issue is how effectively those glitches are fixed, and how quickly that happens.”
Cohen, the HHS official, said no further delays are anticipated. “The individual market will open on time Oct. 1 with full online enrollment and plan shopping,” he said.