Health care call centers an alternative to website? Not really

Phil Galewitz / Kaiser Health News /


Published Oct 27, 2013 at 05:00AM / Updated Nov 19, 2013 at 12:31AM

WASHINGTON — An elderly man calls to ask if the land he owns will count as income to qualify for health coverage through Medicaid. A legal immigrant asks if she can sign up for a health plan through the state’s online insurance marketplace. A broker wants help to become certified to start selling coverage.

It’s 10 a.m. Monday inside the call center of Connecticut’s new insurance exchange established under the Affordable Care Act, the federal health law. On the 21st floor of the downtown Prudential Building, about 25 operators in blue shaded cubicles are talking on telephone headsets while a dozen more callers wait on hold.

“It’s controlled chaos,” said David Lynch, the call center manager for the marketplace.

Centers like these were touted by President Barack Obama last week as one of several alternatives for consumers having trouble shopping and enrolling in plans through healthcare.gov, the bug-ridden website run by the federal government for residents of 36 states.

“The call centers are available,” he said, reciting the telephone number — 1-800-318-2596. “You can talk to somebody directly and they can walk you through the application process. ... Once you get on the phone with a trained representative, it usually takes about 25 minutes for an individual to apply for coverage, about 45 minutes for a family.”

But consumer advocates say the centers were never meant to be an alternative to the insurance exchange website. They were conceived of as a supplement — a way to offer some consumers more help to understand their options.

“The telephone call center is not a realistic alternative to the website,” said Adam Linker, a health policy analyst for the North Carolina Justice Center, a consumer advocacy group. “The marketplace was billed as a place to easily shop and compare plans, but on the phone there is no real way to do that.”

Others agree that the call centers’ representatives can provide only limited help to those who want to shop for coverage. That’s because some states have dozens of plans to choose from, a process that could take hours to sort through on the telephone. In addition, the representatives are also having trouble getting information from healthcare.gov, which affects their ability to verify people’s identities and income.

One healthcare.gov operator acknowledged that she cannot provide exact prices and benefits before a caller answers a series of questions to set up an account and his or her identity. She can offer average premiums in a particular area without going through that process.

John Foley, a lawyer with the Legal Aid Society of Palm Beach County in Florida, which received federal funding to help people navigate enrollment, said call center operators face many of the same delays as consumers because of the malfunctioning federal website.

“We are facing the same glitches on the telephone,” he said. “And even if it were working, it would be quite time-consuming” to go through all the plans a consumer might want to compare. He is advising people to wait until the website becomes easier to use.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said the call center was always “an essential piece of the puzzle” to get people enrolled. She said asking people who really desire insurance coverage to spend an hour or two on the telephone isn’t too much.

“The real challenge for the call center and others helping consumers is that this is a complicated process,” she said.