In the first part of our series we discussed the public faced after the rollout, this final part continues from where we left off. The first post discussed, the top three problems faced by people were that of higher associated costs for people who are not eligible for any Obamacare subsidies, the broken promise of cancelled policies and doctors refusing to take Obamacare enrolled patients. You can read the detailed post here.

In this part, we take a look at the next set of common problems faced by people post October 1, and how they were subsequently handled. Let’s roll.

1) A good chunk of my time has been wasted in getting enrolled – The biggest problem after the launch was the technical glitches that hampered the enrollment process. People tried repeatedly to get into the system and buy health insurance but were unable to access the system. Some people resorted to paper applications and getting professional help from exchange navigators. Although these paper applications were a sure way of enrolling, it was a cumbersome process that required a lot of effort from navigators and enrollees. As time passed and improvements were issued incrementally, the marketplaces became more stable. With the technical issues out of the way, enrollments increased substantially and a large number of people enrolled from January to March 2014.

2) We have fallen in the healthcare coverage gap and cannot get affordable health insurance – One of the biggest flaws of Obamacare rollout was the healthcare coverage gap that came to light in the first quarter of 2014. The healthcare coverage gap, which is defined as the insurance gap in states that decided not to expand Medicaid coverage. Basically, the Obamacare insurance subsidies cover people with income falling in between 138 percent of the federal poverty line and up to 400 percent of the federal poverty line. For people below 138 percent, Obamacare had proposed a compulsory Medicaid expansion. However, with the U.S. Supreme Court ruling out the mandatory expansion, 25 states choose not to expand Medicaid in light of the associated costs for the government. Due to this, states which did not expand Medicaid could not cover the affected demographic, and with no health insurance subsidies for people in this group, they were left to either buy unsubsidized health insurance or stay uncovered.

State Exchange

3) As an uninsured, I am better off paying penalties than paying sky-high premiums – At the outset, Obamacare had one primary aim – to provide affordable healthcare to everyone. However, as Obamacare rolled out and numbers started coming in, one thing was clear – the uninsured were not interested due to the high costs. Most of these uninsured were people falling in the young, healthy individual category. For the self-sustenance of Obamacare, it was necessary that the administration enrolled roughly 40 percent of people from this category. However from the perspective of healthy, young individuals, it made financial sense for them to skip health insurance altogether and pay penalties as required by the law. Naturally, this increased the risk of a death spiral, the term given to internal collapse of Obamacare due to inability to sustain financially. However, with time, this risk was accounted for as slowly and steadily the young invincibles purchased health insurance, either through Obamacare marketplaces or through private exchanges. The marketing efforts, knowledge sessions, and improved enrollment portal collectively contributed to this surge in enrollments of this demographic.

Since the rollout of Obamacare on October 1, the last six months have been full of up and downs. Yes, there have been issues, and yes, there have been efforts from administration, volunteer groups and several other stakeholders towards fixing these issues, and that is why things have become smoother now. In the coming months, more improvements can be expected, and when the exchanges open again for open enrollment, starting on November 15, enrollment should be a lot smoother.

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