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Glut of ACA Sign-Ups Inundates Maine Insurers
02/28/2014   Reported By: Tom Porter

When David and Robin Millward moved to Ogunquit, Maine, in November from London, England, they knew that getting health insurance coverage was a priority - perhaps even more of a priority for them because David has an hereditary heart condition. And so, like thousands of others residents of the Pine Tree State, they enrolled with Maine Community Health Options - one of the two health insurance companies available under the state's online marketplace. (The other one is Anthem Blue Cross and Blue Shield.) But the Millwards say their experience so far leaves a lot to be desired - and the company acknowledges that an unexpectedly high number of enrollees caught them off guard. Tom Porter has more.

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Everything went OK, says Robin, until the last week in February, when they tried to contact Maine Community Health Options - which describes itself as "Maine's first nonprofit, consumer-operated and oriented health insurance plan." All they wanted to do, she says, was pay their monthly premium over the phone, because the company's online pay system isn't yet working.

"Well, both my husband and I, on separate days, rang the number which was on the invoice," Robin Millward says. "It's not, apparently, a dedicated line for paying your bill. It goes through just to a general 'wait-and-see' line."

And 'wait-and-see' is just what they did, spending more than an hour on hold one day, and a further 45 minutes on hold the next - both times unable to reach a human voice.

Robin, who is a native Mainer but lived in England for 38 years before moving back, says she ended up having to mail in a check for their monthly premium, which is more than $1,500. Because she wanted the check sent guaranteed overnight delivery, this cost a further $16.

"So I've had the inconvenience, the expense, all to make sure that we're not left without cover in a country where failure to have insurance cover can bankrupt you," she says. "I find dealing with this company, this month in particular, to be a complete shambles. I think that they're disorganized, their phone system doesn't work, they're inaccessible and their website is pretty poor as well, just for good measure."

"We're working very hard. We take each call very seriously and want to make sure people's issues are addressed," says Kevin Lewis, CEO of Maine Community Health Options, which has seen more than 16, 000 Mainers enroll with it since October. That's about 80 percent of all online marketplace users, says Lewis. The take-up, he admits, was greater than expected.

"We went into this with some high enrollment modeling, and I would say that we were nevertheless still surprised with the number of calls, the average length of call," he says, "and it just takes some time to adjust."

In response, Lewis says the insurer is in the process of tripling the number of call center staff. He also expects an online payment option to be operational through the Maine Community Health Options website in the next few business days.

Anthem Blue Cross and Blue Shield says it too has been adding customer service staff and extending call center hours. In a prepared statement, the company says it has been working diligently to cope with increased call volume, as the end of the individual open enrollment period approaches at the end of March.

Eric Cioppa is superintendent of the Maine Bureau of Insurance, which has been taking calls from Maine residents struggling to come to grips with the new health insurance landscape. He says he understands consumers' frustrations, "because, you know, health insurance is a very important component in people's life, and they want to make sure the 'i's' are dotted and the 't's' are crossed."

But he says it's important to remember that the last few months have been a steep learning curve for everyone.

"This whole process is new," Cioppa says, "and a lot of the rules and a lot of processes coming out of Washington have been subject to change, sometimes with little or no notice. So we all have - and that includes state government - we have to react accordingly in sometimes a very short time-frame."

"We've heard about some issues which I would really classify as capacity issues," says Mitchell Stein, policy director at Consumers for Affordable Healthcare, a non-profit dedicated to making sure all Mainers have access to health coverage they can afford. 

Stein says these capacity issues are largely due to the fact the Maine has surpassed its projected sign-up target faster than any other state - something which initially caught some insurers off-guard.

"Obviously we, as representatives of consumers, wish they had added more staff," Stein says, "but at the end of the day, if these are the worst issues we hear with respect to the customer service then it's not that bad."

If you're having problems dealing with a health insurer, there is help available. Learn more from the State Bureau of Insurance. You can also call the Maine state helpline at 1-800-300-5000.


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