President Barack Obama, accompanied by Education Secretary Arne Duncan, right, visits a math classroom at Pathways in Technology Early College High School (P-TECH) in Brooklyn borough of New York, Friday, Oct. 25, 2013, to highlight the importance of education in providing skills for American workers in a global economy. (AP Photo/Charles Dharapak)
Last week, President Barack Obama said what many people who visited healthcare.gov to browse and buy affordable health insurance already knew: The website, tied so heavily to the success of the Affordable Care Act, wasn’t working properly.
“And there’s no sugarcoating it,” said President Obama during a speech on the Affordable Care Act on Oct. 21. “The website has been too slow; people have been getting stuck during the application process. And I think it’s fair to say that nobody is more frustrated by that than I am – precisely because the product is good, I want the cash registers to work.”
For weeks, visitors to healthcare.gov were greeted by error messages and maintenance pages that implored them to try again later. Some were even kicked out of the application process as they tried to sign up. White House officials called the problems minor glitches attributable to heavy traffic, but those glitches exposed much deeper concerns.
The Washington Post reported that government insiders knew of potential problems before the October 1 launch of healthcare.gov and that the website “crashed after a simulation in which just a few hundred people tried to log on simultaneously.”
According to the newspaper, government officials ignored warning signs and “Despite the failed test, federal health officials plowed ahead.”
The problems with the Affordable Care Act rollout were also compounded by the fact that as White House officials crowed about the website, other modes of accessing the new healthcare exchanges were drowned out of the conversation.
“There are folks who talk about the website challenges, but once people find out that there are multiple paths to enrollment, then the stress seems to go away,” said Etoy Ridgnal, the national director for African American Engagement for Enroll America, an independent, nonpartisan healthcare enrollment coalition. “Most people that I talk to don’t realize that there is more than one pathway to enrollment.”
Anton J. Gunn, the director of external affairs in the Office of Intergovernmental and External Affairs at the U.S. Department of Health and Human Services, said that the Affordable Care Act is more than just a web site – it’s about getting people health insurance. That’s why there are four different ways to enroll: online, by mail, in-person, or over the telephone.
African Americans have a lot to gain with the success of the Affordable Care Act. According to a fact sheet released by the Department of Health and Human Services:
7.3 million African Americans with private insurance now have access to expanded preventive services with no cost sharing. This includes services such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, and flu shots for all children and adults.
An estimated 5.1 million African American women with private health insurance now have guaranteed access to women’s preventive services without cost sharing. These services include well-woman visits, HPV testing, counseling services, breastfeeding support, mammograms and screenings for cervical cancer, prenatal care, and other services.
The 4.5 million elderly and disabled African Americans who receive health coverage from Medicare also have access to many preventive services with no cost-sharing, including annual wellness visits with personalized prevention plans, diabetes and colorectal cancer screening, bone mass measurement and mammograms.
More than 500,000 young African American adults between ages 19 and 25 who would otherwise have been uninsured, including 230,000 African American women, now have coverage under their parents employer-sponsored or individually purchased health plan.
Even as the Obama administration scrambles to fix problems associated with healthcare.gov, Gunn acknowledged that many people, especially in the Black community remain skittish about disclosing personal information on the Internet.
“Not everybody wants to do business online,” said Gunn, an African American. “They don’t bank online, they don’t shop online. There are lots of people in our community like that.”
Ridgnal cautioned against an overreliance on technology.
“Nothing can replace good old fashioned organizing, good old fashioned door-to-door contact, face-to-face contact, the church being a major vehicle for communication,” he said. “There are so many folks within our community on the older side who don’t have access to technology and would never be comfortable registering via a website.”
That’s why the Obama administration funded navigators to help guide people through the process, including community health centers, and certified application counselors in every state.
Ridgnal said that Enroll America focused on having real people reach folks where they are and also used new and innovative strategies to reach people via Facebook, Twitter, e-mail, and text messages.
“Reaching young African Americans and young people of color in general is extremely critical for us,” said Ridgnal. “We are creating a pooled marketplace that will hopefully make prices more affordable for everyone, which means we need a diverse pool of consumers participating so that everyone can benefit from quality and affordable health insurance options.”
In an effort to raise awareness about the healthcare exchanges, Enroll America officials said that the nonprofit aired television ads during the first week that the marketplaces opened on BET and OWN in Dallas and Orlando and OWN and TV ONE in Houston and Miami. They did not advertise in Black newspapers or magazines.
As part of their outreach and education effort around the launch of the Health Insurance Marketplace HHS, a spokesperson for the Centers for Medicare and Medicaid Services (CMS) said that they plan to use targeted television and radio advertising, as well as social media to inform Americans about the opportunities to sign up for health insurance.
The strategy includes high profile spots on the National Basketball Association, the National Football League and Major League Baseball as well as Radio One and BET.com.
But Black print publications, which reach millions of African Americans, are not included in that advertising.
A spokesperson for CMS said that paid print advertising is not part of the media strategy at this time, because research shows that media consumption among young adults focuses on digital, television and radio.
But Black publishers say their products reach all age groups in the Black community, including younger Blacks attracted to their digital platforms. They said failure to advertise in Black newspapers and magazines is a lost opportunity to reach all segments of the Black community.
The strategy leaves many to wonder how effective it will be in reaching poor Blacks with little to no access to the Internet, especially in states that didn’t expand coverage for Medicaid or set up their own state health insurance exchanges.
On the technical side, the administration recently announced plans of a tech surge to address the ongoing problems that users have faced at healthcare.gov. During a teleconference with members of the press, Jeffrey Zients, the management consultant pledged that services would be greatly improved by the end of November.
As IT experts work around the clock to fix healthcare.gov, the Obama administration has also increased staff support at call centers to field questions and concerns people have about the healthcare exchanges.
Kathleen Sebelius, secretary of Health and Human Services, said that the call center has received more than 1.6 million calls, and average wait times for calls was less than 30 seconds, and 3 minutes for chats.
“The call center is an important way for you to connect with someone,” said Gunn. “Just like you would save your brother’s cell phone number into your phone or save your doctor’s number into your phone you should save 1-800-318-2596 into your phone. Share it with everybody that you know who is uninsured and if you have a question, whether it’s three o’clock in the afternoon or three o’clock in the morning, you can call that number and somebody will pick that line up to help you enroll in coverage.”
People who want to apply for health insurance coverage can find instructions here.
Individuals and families can download and print an application for health insurance coverage here and mail it in.