9NEWS political reporter Brandon Rittiman recently used the state health insurance exchange for his family's coverage. What follows is his editorial review of the website.
I'm not going to sugar-coat this: The official state website where Coloradans can shop for health insurance is a mess.
Sure, connectforhealthco.com looks pretty slick at first glance. It lets you window shop for plans and offers some (but not all) good info about the health care law.
But when you actually create an account and start shopping, the site offers an experience that is clunky, counter-intuitive and often confusing.
That's the web product being offered to Coloradans after receiving nearly $179 million in federal grants to develop the state exchange.
At 9NEWS, we get questions and complaints with some frequency about the website, and we often encourage people to call the staff for the exchange and to report back to us if they still can't resolve their issues.
In the review that follows, you'll see the support staff at Connect for Health - which had to complete our sale over the phone - was the only thing that kept my family from abandoning our search for coverage.
To the exchange's credit, we did manage to get a health plan that fit our needs in the end, and that plan was cheaper than it would have been to add my wife to my employer plan.
That success, though, came after a heavy dose of frustration with the web platform.
A DIGITAL DISSERVICE
If you are looking for a passionate argument about the pros or cons of the Affordable Care Act, you should look elsewhere. As a reporter, I avoid making public policy arguments.
However, if this is the official system Coloradans are getting to shop for individual coverage, it should be a good one. Nine months after it began selling health plans, this website isn't a good one.
It should be upsetting to everyone in the state, especially supporters of the healthcare law. My family obtained a health plan despite this website.
By way of background, I am not remotely anti-technology. I grew up in Silicon Valley. I built my own computers as a kid. I once had a job working in tech support for Andale.com, a sophisticated e-commerce platform that has since been acquired by Vendio.com.
My goal in this review is to shine a light on some really basic (and deeply frustrating)problems that any commercial dot-com would be pulling all-nighters to fix.
For some reason, these issues have been allowed to hang around for the better part of a year by Connect for Health Colorado.
I'm used to dealing with very clunky government websites (see the Colorado General Assembly for starters.) Design problems there can frustrate attempts to keep tabs on government, which is very important.
This matters even more. The exchange needs to be able to help people comply with the law and avoid tax penalties. As you'll see, the current design ofconnectforhealthco.com might well frustrate people away from buying a plan, even after they've made the effort to shop for one.
CLICKS TO NOWHERE
My family's shopping experience on the exchange began with good news: a new job for my wife Elizabeth. With her prior employer's coverage set to expire at the end of June, and her new employer not offering insurance until after her second month on the job, we wanted to get her covered in case of emergency.
Before creating an account, we used the site's helpful "browse plans" tool to get a sense of the prices. We were happy to learn that the exchange had several options more affordable than adding Elizabeth to my plan through work. This is also where I started to notice bugs.
After clicking on specific plans for details, we'd return to the results list. Suddenly, the prices and options would all be different. The site had cleared the age and location information from our search.
That night (Friday, June 27), we created an account for Elizabeth to start shopping. We navigated through the forms to establish that she was eligible to buy a plan outside of the open enrollment period.
We found the list of plans and decided to choose one the next day.
That's when it got ridiculous.
I fired up the computer, and (as instructed by the welcome email) pointed my browser to connectforhealthco.com.
Look at the image below. Where would you go to sign in to your account and continue shopping?
If you (like every person I've since posed this question to) picked the big "Sign In" button in the upper, right-hand corner of the screen, you're wrong.
Clicking the "sign in" button does nothing. Hovering over it brings a drop-down menu of three options, none of which offers customers the ability to sign in to their accounts.
At this point, I was confused. So I started clicking around to look for a place to log in.
Where could it be? New customers? Nope. Current customers? No buttons there.
Maybe I could go to the browse plans tool (misspelled as "brows" at several points in my time on the site, an issue that appears to have since been fixed.) No luck there, either.
So we started a chat with tech support.
WORKAROUNDS! A SURE SIGN PROBLEMS ARE KNOWN BUT NOT FIXED
The polite and helpful tech support staff had an answer. A quick answer but not a good one.
Tabitha: Hi, my name is Tabitha. How may I help you?
Tabitha: Good morning Elizabeth. Are you currently logged into your account?
Elizabeth: Not that I can tell.
Tabitha: Try using this link https://prd.connectforhealthco.com/individual then follow these steps Current Customers > View your options > sign in > Click the box under attestation > submit > Sign In
After some initial confusion, because there are two places on the home screen labeled "current customers," (Tabitha informed me I wanted the one "under the girl in the white dress," referring to a stock photo on the homepage) we were able to follow her directions and finally reach a login screen.
For those keeping track: that's six clicks to log in to an existing account. You wouldn't put up with that on Amazon or eBay. If this website were selling anything other than a product people are legally required to buy, I imagine it would go bankrupt.
But it appears to be considered good enough for now by Connect, because the tech support staff was ready with a quick stock answer to this question.
I'm unclear why steps three and four are even needed. We had already gone through the necessary steps to confirm that Elizabeth did qualify for enrollment because of her job change.
And yet, somehow, the website required us to "certify that I understand that open enrollment is closed and I cannot buy a new plan."
That's despite that fact we did understand open enrollment was closed, but we also understood that we could, in fact, buy a new plandue to the qualifying life event in our case.
Linda Kanamine, a spokesperson for the exchange, told me that this step was "a necessary precaution that helps prevent someone from inadvertently purchasing a plan when they are not eligible." They also considered only allowing sign-ups for qualifying life events by phone, but wanted to preserve the ability to shop online.
Once we logged in, there was no "continue your search" button. Instead, Tabitha helpfully walked us through the next three clicks we needed.
First, we needed to click the "my eligibility" tab, which was confusing since we'd already established eligibility the day before. Then, next to Elizabeth's name, we needed to click "detail" - a word that implies you are going to inspect the eligibility information, as opposed to actively searching for a plan.
Only after these poorly labeled steps does "find a plan" appear. On the next screen, I was reacquainted with a shoddy bit of web design I noticed the night before.
Two graphics are meant to helpfully explain the next steps but lure you into clicking on them with action words like "find a plan" and "check out & enroll."
Despite the fact they contain the verbs you want, you can't click on them. The proper choice is "continue" at the bottom of the page.
So, 10 confusing clicks later, we were ready to resume our search. More confusion awaited us.
THE WHIZ-BANG PRICE TOOL (THAT APPARENTLY DOES NOTHING)
At this point, we were asked to reconfirm a multitude of steps (questions we'd already answered the night before) to narrow our list of plans.
One of the first steps is a (seemingly) helpful tool to provide guidance about the costs you might pay under different plans.
A drop-down menu of common major medical services appears, promising to help you estimate the cost of this procedure under different health plans. The options include everything from heart procedures to childbirth.
We tried this out just for grins, and the cost comparison never showed up at any point between making a selection and purchasing a plan.
Connect for Health explained this issue to me as follows: "The Medical Expenses tool was a feature we hoped would be more helpful, but customer feedback was mixed and many thought the tool was confusing. We are removing it when we launch our updated site for the next open enrollment period."
DO I HAVE TO CLICK ON EVERY SINGLE CARRIER?
At another point in the optional pre-screening tool for plans, you come to a page that shows you the logo of every, single health-insurance company that offers plans on the exchange.
Every carrier logo has an unchecked box next to it, and the user is asked to select the companies they prefer.
Deciding that it would be ridiculous to have to manually select each and every company in order to peruse all the plans, we left all the check boxes blank and, fortunately, this worked!
Still, this step would benefit from a disclaimer at the top telling you that checking nothing will show you all plans. Alternatively, the site could have a "select all" button, or it could begin with all the carriers pre-checked so that customers could deselect companies they don't like.
In a related bit of slop, the site has another step that seems very eager to help you find a plan that will allow you to keep your doctor.
This has been a political bone of contention, and I understand why the site would prominently tout the ability to search by providers.
When asked whether we wanted to sort plans to find one that works with our provider, our answer was "no."
But "no" wasn't an option.
We chose, "I'm not sure. Skip for now."
This didn't harm our search in any way, just made us feel like we ought to be ashamed or something for not wanting to use the feature.
WE LIKE TO MAKE YOU SCROLL NEEDLESSLY
Finally, we arrived back at the choices. The exchange showed us 87 plans, helpfully sorted by the cost of their monthly premiums. Annoyingly, the page will only show you 10 plans at a time. There is no "show all" button.
This matters for a couple of reasons.
First, we wanted to compare a bronze plan to a platinum or gold plan. But to do this, you must check a box next to each of the plans you wish to compare. The platinum and gold plans were several clicks away from appearing on the first list of 10, making it impossible to easily compare the two using the website's comparison tool.
Secondly, this lack of functionality paled in comparison to the cursing that was evoked when I finished looking at a group of 10 plans.
Once you scroll below the 10th plan in each group of 10, you will find a button that reads "next."
Do not click this button.
I found myself instinctively clicking "next," every time I finished reviewing a group of 10-plan options.
But rather than show the next group of 10 plans, clicking "next" advanced us to the next step in the exchange's process: browsing dental plans.
To view the next 10 plans on your list, you have to scroll back to the top of the current group of 10 and click the small right arrow.
It's the only way to see more, and it runs counter to common-sense web functionality.
The site also needs to help people better understand some of the plan features. For instance, many plans offer Health Savings Accounts, a useful but complicated type of bank account that helps customers pay medical expenses with pre-tax dollars.
But the site offers no details about the HSA accounts.
"I apologize," customer service rep Tabitha told us in a web chat. "You would have to contact the carrier directly for the details regarding the plans that offer the HSA."
There are many providers that offer HSA accounts with their plans, and we weren't willing to call several of them to poke and prod into their HSA options.
I could also see customers being confused about things like co-insurance and copays.
User-friendly information to de-mystify the healthcare jargon in the shopping space is planned for the future, Connect for Health told me.
CLOSING THE DEAL POORLY
We picked the plan we wanted and decided to proceed to checkout and BAM!
Panic ensued. Had we just lost everything we spent the last several hours working on? Fearfully, I clicked my browser's "back" button and tried again. This time, it worked. We were presented with a summary of our plan choices.
A sigh of relief, until we next came to the page of options to pay for the first month's premium:
We were offered only one option: pay by paper check.
The exchange says electronic payments are coming, but the feature isn't ready yet. Because Connect for Health Colorado does receive the payment (the insurance company does,) the website needs to seamlessly pass the payment information through to carriers. "We are in the process of testing with a number of our carriers and will implement on our site as soon as each carrier is ready and we are confident it works safely and securely for you," said exchange spokeswoman Kanamine.
I put away the credit card and clicked "continue," afraid of what this would mean for the effective date of Elizabeth's coverage.
The information displayed on the next page did not ease our concerns.
The site informed us the bill would arrive in "7 to 10 business days" and that we "must submit full payment in order for your coverage to begin."
This led us to believe that Elizabeth would lapse in her health coverage for about two weeks.
We went through this process on Saturday. Her former employer's plan was going to expire the following Monday.
At this point, we called customer support to see if we could cancel everything we'd just done, willing to pay more to cover Elizabeth on my employer plan.
THANK GOODNESS THE PHONE STAFFERS KNOW THEIR STUFF
At this point, we were connected with a friendly and knowledgeable phone rep named Rachel.
We told her we wanted our coverage to begin on July 1 (the next coming Tuesday), and she informed us "as soon as you pay the bill, then they will start the coverage as of July 1."
In other words, we would be retroactively covered in the event Elizabeth needed medical care before the bill arrived, so long as we applied before the end of June and paid the bill when it arrived.
Out of curiosity, I wanted to know what would have happened if we hadn't purchased a plan. Would we be subject to a portion of the Obamacare penalty on our income taxes?
"The penalty only comes in after you've gone 90 consecutive days [without insurance,]" Rachel said.
That was news to me, and was not featured anywhere on the pages that help you determine whether you qualify for a new plan outside of open enrollment.
I did search after the fact, and on a page titled "federal requirements," Connect for Health does disclose this fact at the very bottom of a long list of details.
I imagine others would like to know this information so they can decide whether to take their chances without insurance after leaving a job.
We still wanted coverage, just in case.
Rachel also informed us that the exchange has plans to add credit card payments in the future, to avoid paper checks as the only option.
She eased the worry evoked by the website, completed our purchase over the phone, and provided a reference number to prove that our plan is supposed to begin on July 1, even though the website shows that our coverage won't begin until Aug. 1.
POSITIVES TO BUILD ON
We're still waiting for Elizabeth's bill, insurance card and welcome kit.
As stated earlier, we did manage to get coverage at a better rate than otherwise was available to us. That's a lot better than most people could say for COBRA alternatives in the past.
The plan options were nothing to sing about from the rooftops, but they were fine. And the site seemed to do a good job of helping figure out whether there might be subsidies available to bring down costs.
Despite its clunky navigation, the plan prices and features were mostly clear and understandable.
While it could do a better job of providing helpful information during the process, the site has a pretty good tool for finding answers to common questions. For instance, we wanted to know details about canceling the exchange plan when the time comes. Those answers were easy to find.
And lastly, the customer support people I dealt with were top-notch. I imagine they deserve a lot of the credit for the sign-ups the exchange has managed to sell so far.
WHAT HAPPENED? AND WILL IT GET BETTER?
My goal in sharing this story is not to embarrass the team at Connect for Health, though they should be embarrassed by some of these very fixable problems.
After all the spending and planning to build this system, both sides should be asking questions about the pay raise and bonus offered to Connect's CEO Patty Fontneau.
State lawmakers killed a bill that would have audited the exchange's spending to build this website. They should revisit that decision. What's the harm in finding out how this happened and learning from it?
It might provide useful insight in the next step that needs to happen: fixing the website.
Repairing this sloppy site is something that should unite critics and supporters of Obamacare. If supporters of the ACA really want to get people covered, they should know that this website could do a much better job of it. If opponents want to repeal Obamacare, they should still want to minimize difficulty for everyday folks while they advocate that position.
Connect for Health says its website will get a re-boot, version 2.0, before open enrollment begins again this November.
"We are intently focused on making critical changes to online system for the upcoming open enrollment period," Kanamine said. "We are also working with our solution vendor to make refinements to screen text and page functions to make the process more intuitive for online shoppers."
It's my sincere hope this reboot will be as advertised, making the official online gateway to the exchange better. We'll follow up to see if it is.
I can only imagine how daunting the current website must seem to people who don't wholeheartedly embrace technology.
I cash checks on my smartphone, shop online frequently, and maintain numerous social media accounts for work and pleasure -and I had an awful experience trying to navigate this system. To serve people who don't do much business online, this site needs to be easier to use than my bank's smartphone app.
That will be a tall order because Connect is selling a complicated product, but it's what the people of Colorado deserve. Health coverage is complicated enough as it is, and the state's official website needs to help cut through the confusion, not add to it.
Otherwise, we might as well stop offering people the ability to complete their purchases online and complete the process by phone instead.
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