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Health exchanges use paper forms to start insurance enrollments as websites fail

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By The Washington Post

Published: Saturday, Oct. 12, 2013, 6:45 p.m.

The dead-tree version of health insurance enrollment is turning out to be popular, but processing paper is likely to add to delays and will further complicate a process that was supposed to be one-stop shopping, experts say.

Unable to use new government insurance websites plagued by technological problems, those tasked with helping the uninsured sign up are bypassing them, relying instead on old-fashioned paper applications.

It is a slow and labor-intensive substitute for what was supposed to be a snappy online application, similar to Amazon or Travelocity.

“These are low- to moderate-income people, stopping by on their lunch break, between picking up their kids. They don't have time to mess with a website that doesn't work,” said Marie Hurt, executive director of Southern United Neighborhood, a New Orleans-based charity that is helping people enroll in coverage in three states.

She is encouraging people who stop by her center, inside a church, to avoid the federal website for now and use the paper enrollment form.

Timothy S. Jost, a law professor at Washington and Lee University who specializes in health policy, said filling out paper applications does give people the sense that the “process is under way,” he said. But he added: “It will add to delay. It will add to errors.”

Paper may give people the impression that something is happening when an online system isn't functioning properly. In fact, that's not the case, said Kevin Counihan, executive director of the Connecticut exchange, Access Health CT.

Personnel reviewing paper applications need to manually type data from paper into the same Web-based marketplaces that consumers are using. Reviewers are entering through a different “portal” than one consumers use. But it's the same online system.

“If you don't have a working [online] system, paper doesn't do you any good. It's almost worse because there's this illusion that you've finished something,” Counihan said. “When in fact, it's just getting stacked up waiting for the system to work.”

The paper process is clunky and prone to errors. And it provides “a substandard user experience,” he said.



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