How Does ACA’s First Week Compare to Medicare Part D’s?

By Jack Hoadley, Georgetown University Health Policy Institute

Since the official opening of health insurance marketplaces on October 1, there have been reports of broad interest and high traffic to marketplace websites, but also of various glitches and delays with those websites.  Back in the fall of 2005, there was a similar launch for Medicare’s new Part D prescription drug benefit.

Does this excerpt from an article from the Washington Post of November 8, 2005, sound familiar?

The rollout of the new Medicare drug benefit has been anything but smooth. At a news briefing yesterday, Mark B. McClellan, head of the Centers for Medicare and Medicaid Services, provided a how-to demonstration of the much-awaited Medicare Prescription Drug Plan Finder, which he said would be available on by 3 p.m. It wasn’t. … Problem is, the Medicare folks have had some trouble getting the tool up and running. The original debut date was Oct. 13, but officials delayed it, citing the Jewish holiday Yom Kippur. Next it was promised on Oct. 17, but that day, too, came and went without personalized plan comparisons being available. Late in the month, McClellan told reporters that the feature definitely would be ready before Nov. 15, the date when seniors can begin signing up for the drug benefit. Yesterday [November 8], McClellan announced that the time had come. … But the tool itself appeared to be in need of fixing yesterday. Visitors to the site could not access it for most of the first two hours. When it finally did come up around 5 p.m., it operated awfully slowly.

Even though there were problems this week, marketplace websites were at least up and running on the promised day, October 1.  As reported by HHS officials, there were nearly 5 million visitors to on the first day, far more than have ever visited  During the 2005 signup period for Medicare Part D, the number of daily visitors to the online Plan Finder peaked at about 160,000 for a program that would enroll more people than are expected to enroll under the Affordable Care Act.  By this standard, the level of interest in getting online information from the marketplaces is remarkable.

Seniors in 2005 were more likely to use the program’s 1-800-Medicare call centers than the online resources, but the daily volume there never exceeded half a million callers.  The call centers experienced both dropped calls and frustrating wait times to get through, especially in the first days and weeks.

Based on the Medicare Part D experience, we can experience some decline in interest in the health insurance marketplaces after this first week.  But there should be steady volume of website use, phone calls, and visits with counselors throughout the fall.  Medicare Part D then experienced another surge of interest as the December enrollment deadline for coverage to begin on the first of the year.

Glitches continued with the Part D website and call center throughout the open enrollment period.  But the program added both phone lines and customer service representatives and implemented other upgrades over the weeks.  The website – both its functionality and the accuracy of its information – was the source of ongoing frustration for its users, but it did get better over time.

By the end of open enrollment in May 2006, over 16 million successfully enrolled for drug benefits in Part D (not counting another 6 million automatically enrolled as a result of participation in both Medicare and Medicaid).  Initial glitches did not deter their enrollment.  And today, Part D enjoys widespread popularity.

The author is a research professor at Georgetown University’s Health Policy Institute, where he conducts research projects on health financing topics, including Medicare and Medicaid, with a particular focus on prescription drug issues. He is the lead author on a recent report – “Launching the Medicare Part D Program: Lessons for the New Health Insurance Marketplaces.“

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