The national health exchange has now been open for one month. Technical difficulties persist on both the federal health insurance website and ConnectforHealthColorado.com (C4HCO). At times the sites have worked slowly, crashed or reported errors. As of Oct. 7, Connect For Health Colorado reported 226 Coloradans had enrolled in the exchange. An exchange spokesperson declined to give an update at press time for the Front Porch. 

However, medicaid, which expands to include more people through the Affordable Care Act, is on track to enroll 25,709 Coloradans for coverage beginning January 1, according to the Colorado Department of Health (as of October 24).

“As long as these substantial technology glitches persist, we are losing valuable time to educate and enroll people in insurance plans,” said Colorado Senator Mark Udall. Fearing that federal and state websites will not be fixed in time for people to enroll, he and eight senators, including Michael Bennet, joined a coalition urging an extension of the enrollment deadline.

Despite the glitches, Stapleton Foundation Vice President of Community Health Alisha Brown says the process is going well. It does, however, require more steps than people expected.

Brown runs the health care enrollment program at the be well Health & Wellness Initiative, a group that helps NE Denver and NW Aurora residents take charge of their health. She and her three primary health care enrollers assist people through the process, as well as present information to businesses and small groups.

Brown says the volume of enrollees has been manageable so far—right now her staff is enrolling about three to five people a day. She expects more people will sign up closer to the deadlines—Dec. 15 for coverage beginning in January or March 31 for coverage beginning in April.

Initially, they anticipated the enrollment process would take 30–45 minutes, but some have taken nearly an hour and a half, depending on the individual. Brown says the people they have worked with so far have been “patient and gracious” about the process.

Originally the site was advertised to be like Expedia.com and instantly compare plans and subsidies side by side. The reality is more complicated. To find whether you qualify for premium subsidies, you are transferred from the C4HCO website to the PEAK website (which determines Medicaid eligibility) and fill out a Medicaid application. Right now, 30 percent of those applications get immediate responses. Most people have to wait to find out, delaying the next step. If you do not qualify for Medicaid, you must call the Colorado for Health customer service line and speak with a representative about other options for financial assistance. If you do qualify, you get a letter in the mail and continue the process. Enrollers at be well follow up with these applicants to make sure the process goes well.

Donna Tirone, an account manager at Hub International Insurance Brokers and Consultants in Denver, has not had a good experience with the website so far. She recently walked through the process with a client who owns a small business. “Let me tell you he is not a stupid man, but he was very confused,” she says. “At one point, he thought none of the plans had co-payments. He is pretty savvy so I can only imagine someone who doesn’t know insurance.”

Tirone’s co-worker, Linda Regalado, says she gave up after three attempts to enroll her sister.

Regalado believes enrollment numbers are low for a reason. “I think people who have been insured in the past and are healthy are going to continue to buy insurance. But I think people who didn’t buy it in the past who are healthy will continue to avoid buying it.”

She believes there is a lot of confusion about the exchange. “There are a lot of misconceptions that this will be health care for all without any further consideration of how it will be paid for.”

The Colorado Health Op is also finding people are confused. The co-op is a consumer-driven public option in the exchange. “They see us as a choice but don’t always know much about us,” CEO Julia Hutchins says. “There’s a continual challenge to educate people that we exist and share some of our history.” She says most people don’t understand how co-ops work and what “member government” really means. (See article on the co-op in the October issue of the Front Porch on page 19.)

The co-op continues working to get the word out—they now advertise on TV, host educational events around the state and help people enroll. Hutchins has not heard back from C4CHO the number of people enrolled in the co-op so far but hopes to know soon.

“We’re really hoping they continue to streamline the process and make it easy for people to sign up. I think that will get better with time.”

To learn more about the Colorado health exchange or shop for insurance, visit connectforhealthco.com. To learn about Colorado Health Op, visit www.cohealthop.org. To schedule an informational presentation or get help enrolling through be well, visit bewellconnect.org or call 303.468.3239.

Find out how the health exchange affects you in the chart below, posted in the October Front Porch.