What doesn't work, DeVito and others say, is known as "direct enrollment." That is the term for people signing up in Obamacare plans, particularly ones that include subsidies, directly through individual insurance companies and web brokers—without the consumer having to go online themselves at HealthCare.gov to apply, shop for plans, and sign up there.
Obama administration officials have said that direct enrollment is available as an option and that it's up to insurers and brokers to decide when to "go live" with it. But industry sources say the reality falls far short of the administration's promise.
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Asked how many people will end up not enrolled for the 2014 plan year because insurers and brokers have been stymied by direct enrollment issues, DiVito said, "It's got to be over a million people, easily, at this point."
That was echoed by another broker executive, who said, "A million people being left on the table? For sure."
"It's just been too much of a mess," said that executive, referring to the continued delays in getting an effective direct enrollment link set up.
One million people equals 14 percent of the 7 million individuals federal officials originally estimated would enroll in Obamacare insurance nationally by the end of open enrollment on March 31, 2014. Total enrollments to date have fallen far short of the pace needed to hit that target.
Flexibile Benefit, like other brokers such as GoHealth and GetInsured, has developed an enrollment workaround for HealthCare.gov. That has lead to some enrollments, but nowhere near the volume that was expected for direct enrollment as designed.
DiVito's company essentially piggy-backs on Illinois Blue Cross' website to get customers to HealthCare.gov, and then bring them back to complete the sign-up and get a commission for the sale. But the process is time-consuming, as are the other workarounds, and it restricts Flexible Benefit customers' choices to just Illinois Blue Cross plans.
"It's tedious, it's a lot of work," DiVito said. But he added that "we are seeing a success rate significantly better than we saw three weeks ago."
"You know, it's unfortunate that there aren't more avenues for people to get in," said Larry Levitt, senior vice president of the Kaiser Family Foundation and former White House senior health policy advisor. "Opening up direct enrollment would likely increase enrollment."
Levitt said that if HealthCare.gov—which has undergone dramatic repairs—"operates smoothly over the next couple of days and is able to handle the volume" of people trying to buy insurance before Monday's deadline for coverage beginning Jan. 1, "then I don't think enrollment [overall] will be significantly depressed."
But, Levitt added, "I think it could have been quite significant in October and November," when direct enrollment was essentially impossible via HealthCare.gov, and the federal site's tech troubles were extreme.
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Robert Laszewski, president of the consulting firm Health Policy and Strategy Associates, said that federal officials missed a significant opportunity to boost sign-ups by enlisting web brokers earlier as major avenue for enrollment.
"I think it would have been a big help. While direct enrollment for a single carrier would be helpful, people would not have gotten to shop," Laszewski said. "But if they had done the web brokers like eHealth it would have been about the same as what HealthCare.gov would have offered for a shopping experience. I think it was a big mistake for the feds to not have this in place as a Plan B workaround on October 1—would have saved a lot of grief!"
Centers for Medicare and Medicaid Services spokesman Aaron Albright said, "Consumers can and are signing up for a quality, affordable health plans via direct enrollment today. So far, we have entered into agreements with more than 30 web brokers toprovide this important service for consumers."
"While we continue to be in active discussions with insurers and web brokers on ways to improve the process,direct enrollment through an insurance company or web broker remains a viable option for consumers right now," Albright said.