Even after applying, customers must call or go online to enroll in a specific plan. | REUTERS 'Glitches' hit ACA paper process

Trying to sign up for Obamacare the old-fashioned way — paper, pen or telephone?

Good luck with that.


With the supposedly state-of-the-art $600 million HealthCare.gov portal malfunctioning, President Barack Obama is urging Americans to go ahead and try to get health coverage by mailing in a paper application, calling the helpline or seeking help from one of the trained “assisters.”

But the truth is those applications — on paper or by phone — have to get entered into the same lousy website that is causing the problems in the first place. And the people processing the paper and calls don’t have any cyber secret passage to duck around that. They too have to deal with all the frustrations of HealthCare.gov — full-time.

( See POLITICO's full Obamacare coverage)

“I feel like we’re sort of back in the era of control-alt-delete where we’re trying to figure out the different tricks that facilitate people’s enrollment,” said Jennifer Ng’andu, director of health policy for the National Council of La Raza, a Hispanic advocacy group that has been helping to publicize the Affordable Care Act.

The administration for the first time on Friday said it expected the health exchange website serving 36 states should be in good shape in about a month. “We’re confident by the end of November, HealthCare.gov will be smooth for a vast majority of users,” said Jeff Zients, the former White House aide and management expert brought into oversee the repair drive.

But for now, with HealthCare.gov crippled by design flaws and a morass of messy code, the president and health officials have been using a variety of posts and announcements to urge people to try low-tech ways of enrolling. Basically they are saying while the front door is stuck, try the side.

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Of course, reading an 800 number on national TV — as the president did in the Rose Garden the other day — created a flood of callers who couldn’t get through. That led to another wave of frustration and Obamacare punch lines. But Health and Human Services Secretary Kathleen Sebelius tweeted on Thursday that HHS bulked up the call center to include more than 10,000 trained representatives.

POLITICO reporters who got recorded announcements earlier in the week — sometimes directing them to try HealthCare.gov — can now get through to the call center. Once they connect, staffers like “Justin” try to get people’s information into the online system.

But “Justin” doesn’t have a fast track. Asked if the website works better for him than the general public, he responded: “No.”

“The site does not work for us either,” he said.

( Understanding Obamacare: POLITICO's guide to the Affordable Care Act)

Sometime, the call center staff can get in and process the application while the caller waits. If not, the staff can take the information, put it in a PDF and finish later. Even then, it’s just the application — once that’s processed, the customer still has to call back or get online to select the specific health plan they want and enroll.

People do not have to stay on hold indefinitely — a good thing because Sebelius said earlier in the week that the center has handled about 1.6 million calls.

It’s similar in the world of paper applications.

Even before the tech problems, the government had a private contractor, Serco, to handle paper applications, which were expected to come primarily from less Web-savvy people. On Thursday, the company’s program director John Lau told the House Energy and Commerce Committee that it had completed between 3,000 and 4,000 applications.

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Lau said the company does have the capacity to handle more than what’s expected — a paper surge. But he also said the customer’s data has to be entered into the Web portal and hinted there could be problems if volume dramatically increases. Lau didn’t say how long that takes, but a customer service representative said it would take about three weeks to complete the enrollment process.

“Our challenges have included coping with the performance of the portal as that is our means of entering data just as it is for the consumer,” Lau said, referring to HealthCare.gov. “With the relatively low volumes of applications we have received thus far, this has not been a problem for us.”

But Serco will be flooded with paper applications if the website glitches persist, predicted John Gorman, founder of the Gorman Health Group, which has advised some of the insurance exchanges. “Serco is going to be swimming in paper within the next two to three weeks,” he said.

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Health industry experts have serious doubts about whether these quaint tools could get the Obama administration a good way toward its first-year enrollment target of 7 million Americans in the exchanges by the end of March.

“There’s no way a call center can handle 7 million enrollees between now and March,” said Dan Schuyler, director of exchange technology for Leavitt Partners.

The National Council of La Raza, Ng’andu’s group, has been working with navigators and assisters, more of whom are getting certified every day to help people sign up. They’re getting the clear message from the administration — only use paper applications if nothing else works.

“We’ve been strongly urged to enroll people online and the paper application is the last resort,” said Michele Cullen, manager of the navigator program for the Genesis Health System in Illinois and Iowa.

( PHOTOS: Obamacare online glitches: 25 great quotes)

In the end, everyone trying to enroll Americans in Obamacare just wants the technology to get better.

“It will be nice when that website just flows and we can get people enrolled,” Cullen said.

But the approaching Dec.15 deadline to get coverage starting Jan. 1, combined with the paper and call center challenges, have left advocates trying to enroll people any way they can while keeping their fingers crossed that HealthCare.gov will improve.

“At this point, we’re three weeks into enrollment,” Ng’andu said. “We’re not going to wait. … From our perspective, we need to get individuals informed. We need to get them shopping.”

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