On their first venture into the real world of health care insurance, Obamacare’s 24 health care cooperative start-ups did not enjoy a banner first day.
The nonprofit ventures are a $2 billion Obamacare experiment to create nonprofit health insurance cooperatives designed to compete with commercial health insurers.
Known as Consumer Operated and Oriented Plans, they pledge to provide high-quality consumer-oriented service, openness and transparency.
Typical of the pro-consumer sentiment prevalent among the cooperatives is Arizona’s Compass Cooperative Health Network, which describes itself as “cooperative in every way — a joint effort working closely together to find better solutions, to communicate openly, and to support and encourage each other by always putting our members first.”
But on the first day of service, consumer convenience wasn't apparent on many of the Obamacare co-op websites.
Sites were difficult to navigate and provided little understandable insurance information on topics like eligibility, costs and benefits.
None of the co-ops offered evening or weekend customer service. Half did not identify their boards of directors.
Even just finding the new co-ops online was a challenge, which was further complicated by the fact most of them are all but unknown in their states.
Ohio’s health co-op, legally known as Coordinated Health Plans of Ohio Inc., for example, cannot be found anywhere regardless of search words.
The U.S. Department of Health and Human Services awarded the Ohio group $129 million in October 2012.
Health CO-OP of Michigan’s website crashed a number of times Monday and regularly sent consumers to the wrong page.
Consumers could not find Tennessee’s Community Health Alliance cooperative without spelling out the full formal name. A consumer who searched just for a "health co-op in Tennessee," for instance, would be sent to a mental health cooperative in Nashville. The Community Health Alliance site appeared eight listings down.
The same misdirection occurred when clicking on Nevada’s formal name for its health cooperative: “Hospitality Health CO-OP.” Those words sent visitors to a site listed as “Not Found.”
Without explanation, Arizona's Compass Cooperative Health changed its name to Meritus Health Partners, redirecting visitors to a different site.
Similarly, the Freelancer’s Union changed the names of its three sponsored health co-ops. The New York-based organization operates Obamacare co-ops in New York, New Jersey and Oregon.
Together Freelancer’s won the single largest federal award of $340 million. Freelancer founder Sara Horowitz, a former colleague of President Obama, changed the name of the three new co-ops to “Health Republic, US.”
It is not clear why the organization opted for the name change, but in 2011 and 2012 the New York Insurance Department reported the original Freelancers Insurance Co. was rated the state’s worst insurance provider for consumer service.
There were other indications that some co-ops were not ready. The Kentucky outfit promised on its website “Registration coming soon.” New Mexico’s Health Connection promised the same of its "Frequently Asked Questions" page.
Although all of the Obamacare co-ops promise to specialize in health insurance for the working poor, none of them, at least initially, offer evening or weekend service when their customers would be home. Customer service is only available from 9 a.m. to 5 p.m.
Half a dozen of the Obamacare co-op sites do not explain levels of insurance, premium costs, or out-of-pocket deductibles unless the customer enters personal information, including annual income.
ColoradOP, for example, provides subsidy information for low-income applicants, but does not spell out costs or benefits for consumers. Neither does the co-op explain the four federally recommended levels of coverage, called bronze, gold, silver and platinum.
Some of the Obamacare co-op web sites do provide excellent benefit and expense information. HealthyCT in Connecticut, for example, details four typical benefit levels and costs in only two clicks and without asking for personal information.
There are income eligibility requirements for different levels of health insurance, but in 10 of the co-op sites, consumers are offered no income eligibility or tax subsidy information unless they contact specific insurance companies.
Some of the sites, like Utah’s Aarches health co-op, feature a clear chart with actual costs with the subsidy. Nevada’s co-op provides a convenient “subsidy calculator.” But for 15 other co-ops there is no easy way to find subsidy information.
None of the co-ops post their application for insurance coverage. The federal application is extremely complicated and intrusive, especially for low-income and immigrant customers.
It also can be difficult to find a doctor or provider within a co-op network. Some like Minuteman Health in Massachusetts offer multiple doctors, but others have no directory of participating physicians.
Maine’s community health invites consumers to click to find doctors, but there are few available. For affluent Bar Harbor, for example, the co-op lists only two family physicians.
The Maryland Obamacare co-op site told inquirers that there are no doctors available in Columbia, a prosperous suburb to both Baltimore and the nation's capital.
Eight of the Obamacare co-ops offer no Spanish language site despite the fact that more than 30 percent of Hispanics under the age of 65 are uninsured in 28 states, according to the U.S. Census Bureau.