A series of internal Obama administration memos obtained exclusively by ABC News reveal for the first time how dysfunction with HealthCare.gov has upended the entire Affordable Care Act enrollment process, including applications by paper and phone that officials have been pushing as more reliable alternatives.
While President Obama and other top aides have publicly reassured frustrated consumers that they can bypass the troubled website and apply by phone in as little as 25 minutes, those working most closely with the rollout acknowledged privately that even the nonelectronic avenues would be no more efficient or guaranteed, the documents show.
“The same portal is used to determine eligibility no matter how the application is submitted (paper, online),” reads a Center for Consumer Information and Insurance Oversight memo from Oct. 11.
“The paper applications allow people to feel like they are moving forward in the process and provides another option,” it says. “At the end of the day, we are all stuck in the same queue.”
The documents show that officials decided reluctantly to encourage consumers to fill out paper applications to buy more time and tame mounting frustration with the website.
Initially, administrators of the enrollment process appeared wary of such a directive, knowing that it would not necessarily be faster and could be more labor-intensive for contractors processing the mail. But, ultimately, the memos show, officials decided to embrace paper applications to avoid losing the interest of potential enrollees.
“Navigators are seeing people very frustrated and walking away, so they are turning to paper applications to protect their reputations as people in the communities who can help,” a memo from Oct. 15 noted, “even though the paper applications will not have a quicker result necessarily.”
The documents – informal “war room notes” prepared daily by senior staff inside the Department of Health and Human Services – were turned over last week as part of a document request to the Republican-chaired House Oversight Committee, which is investigating the rocky rollout of the insurance portal.
On Oct. 21, as Obama promoted use of paper applications at a Rose Garden event, the memos show, official guidance went out to health insurance navigators to “use paper applications rather than go through the call center,” a concerted strategy despite the fact that it promised to be no more smooth.
As of Oct. 18, Serco, one of the contractors tasked with facilitating the enrollment process, had received roughly 3,000 paper applications, according to the documents.
In testimony last week before the House Energy and Commerce Committee, HHS Secretary Kathleen Sebelius conceded that paper applications completed by mail or over the phone would face delays due to the website’s technical glitches.
“They put the application into the site and get a determination,” she said of Serco’s handling of paper applications Oct. 30. “That’s part of what the process is. So the site is part of the portal all the way through.”
On the very same day, when access to HealthCare.gov was denied because of technical outages, Obama was on the stump promoting paper and phone applications as an easy alternative to the website.
“Ultimately, this website, HealthCare.gov, will be the easiest way to shop for and buy these new plans. But, look, there’s no denying it, right now, the website is too slow, too many people have gotten stuck,” Obama said at an event in Boston Oct. 30.
“In the meantime, you can still apply for coverage over the phone, or by mail, or in person,” he said, “because those plans are waiting and you’re still able to get the kind of affordable, reliable health insurance that’s been out of reach for too many people for too long.”
Senior administration officials say the President knew that those calling into the call centers and applying by mail would ultimately have to go through the very same troubled system as those going to HealthCare.gov, but that that the callers have the benefit of not having to deal with the website itself.
“The benefit of the call center is that in addition to a representative being able to enter your info directly to the website, he or she can fill out an application for you manually over the phone if the website is not working,” the official told ABC News. ”The reps then enter the application into system later. That’s why we sent people to call centers why website was slow or, in the case of a few days last week, down entirely.”