Mary Leta Wells gets frustrated when Kentucky's system for signing people up for health insurance is held up as a bright spot in the troubled federal roll-out of the Affordable Care Act.
Wells, a 59-year-old office manager from Cynthiana, has been trying since mid-October to get her application through the system and learn whether she might be able buy insurance at a discounted rate because of her income.
The operators at the call center, which can help people navigate the website, have been helpful, she said, but there have been conversations and no resolution.
"I have a folder full of letters telling me that I will be notified by text and email, they sent me a paper application ...," said Wells, who wants to make sure she has new coverage before she runs out of COBRA in the spring. She had insurance at a previous job but signed up for COBRA when she became unemployed. Her current employer doesn't offer health insurance.
"Have you ever been so frustrated you wanted to tear your hair out?" she said. "Am I the only one?"
The answer is no, exchange officials said, and they say they are working to improve the state system which, as a whole, is working well.
The federal website, HealthCare.Gov, has been plagued by problems. Though the federal system is handling enrollment for dozens of states, it enrolled only about 25,000 people in its first 30 days.
Kentucky's program, Kynect, has enrolled 56,422 Kentuckians as of Nov. 22, said Carrie Banahan, executive director the Kentucky Health Benefit Exchange.
An additional 22,000 have entered personal information through the website and have found they are eligible for subsidized insurance but have yet to pick a plan, she said.
Still, in a system as complex as Kynect, some issues are to be expected. The state does not keep statistics about what percentage of applications have problems.
The website, Kynect.Ky.Gov, began accepting applications Oct. 1, and "glitches along the way are to be expected," said Chris Clark, technology manager for the Kentucky exchange.
Cara Stewart, an attorney with the Kentucky Equal Justice Center, a nonprofit advocacy group, has been traveling the state to tell people about Kynect and the health insurance options. An ardent fan of the program, Stewart said one "known glitch" involves the website being unable to confirm someone's identity.
Updates to the software have been issued to address that problem, and Clark said that 92 percent of people are now able to have their identity confirmed. The rest, he said, are handled manually by staff dedicated to the task. In some cases information has been entered incorrectly or the person has no credit history, which is one of the ways their identity is checked, he said.
Updates to the software have been issued to address persistent problems as they become available, Clark said. And a tiered system has been created that transfers difficult problems to the appropriate person to fix.
The first tier is the operators at the call center, which can be reached at 1-855-459-6328.
Nancy Kukulinsky, a retired professor from Mount Sterling, tried in vain to help a friend sign up via the website and eventually called the call center. Kukulinsky, who spent 40 years working in health care, had success with the call center operator.
"I spoke with a helpful woman who said she could complete the application over the phone. We were done in 10 minutes versus the hours I spent online," she said. Kukulinsky was less than pleased with the overall process, although she was glad it resulted in her friend receiving much-needed health insurance. Now, she said, she tells her friends to skip the website and call the call center. "I don't know how many people I have told to pick up the phone."
If the call centers can't fix a problem, the information is passed along to tier two, the staff at the Kentucky Benefit Exchange, Clark said. People who feel like they are not getting a resolution to their problem through the call center operator can asked to speak to a supervisor to see if their problem should be passed along, Banahan said.
The third tier of assistance is to pass the problem along to the experts in the "command center," where Clark and his technology staff keep a log of all the issues, look for patterns of problems and create systemwide software updates to handle persistent errors.
Some improvements to the system were in the works before enrollment began, he said. And monthly minor tweaks to the system are taking place. In mid-December, a number of new features will be added to the site to make it more useful for people assisting others in signing up for insurance, he added. "We are working on it all the time."
And Otis Smith, 28, will keep trying to sign up for health insurance. The unemployed motorcycle mechanic from Corbin started the process on Oct. 1 but has run into problem after problem. He's persisted, not only because it is the law, but because he is in need of health insurance after being hospitalized twice this year with blood clots.
Since he hasn't been working, he is likely to qualify for Medicaid.
He's not thrilled to have to be part of the crowd in need Obamacare. Because he had been generally healthy, he went without health insurance for several years. But, he said, he sees the program as a tool.
"I honestly don't see myself using Obamacare for that long, because ever since I have gotten out of the hospital for the blood clots in my lungs I've been focused on getting healthy and back to work," Smith said.
Affordable Care Act: Also known as Obamacare, it is a law that requires every American to sign up for health insurance by March 31, 2014, or face a penalty.
HealthCare.Gov: It is the federal website being used by most states to comply with the federal law and enroll those with health insurance in new policies. It has been hindered by technical glitches and enrolled fewer than 25,000 Americans in the first month.
KyNect.Ky.Gov: The website, or exchange, for Kentuckians to enroll in insurance. Since it started enrollment on Oct. 1, about 56,000 Kentuckians have enrolled.
To learn more: Go to Kynect.Ky.Gov or call 1-855-459-6328.