The stimulus bill spends billions to help more Americans buy affordable health insurance. But getting those dollars will take some work, and some waiting.

By Margot Sanger-Katz and Sarah Kliff

The new stimulus bill made tens of millions of Americans eligible for new health insurance subsidies. But many will have to wait to get help: It will probably take a year for the full emergency aid to reach people, because of website complications and other logistical problems.

President Biden has promoted the subsidies as fulfilling his campaign promise to shore up the Affordable Care Act. And for many uninsured Americans, the new program will offer free or inexpensive health plans that were previously unaffordable.

But the health law’s complex structure makes it hard to retool insurance subsidies, let alone create a new program for the unemployed. The systems that distribute the benefits depend on government coders who update websites, and marketers who help people understand the new programs and jump through various administrative hoops to collect them.

“I don’t think there is enough Xanax out there for this,” said Jodi Ray, project director at Florida Covering Kids and Families, which manages the state’s health law outreach efforts.

Memories of Healthcare.gov’s notoriously bumpy 2013 rollout still linger in the minds of those overseeing the new update. The debacle quickly became a punchline for late-night television hosts, and a political liability for an already divisive law.

Now, it’s a cautionary tale of a federal government website unprepared for a deluge of shoppers.

“Technology is not self-executing — it takes work,” said Joel Ario, a managing director at the health consulting firm Manatt and a former official in the Obama administration before Healthcare.gov’s launch. “That’s unfortunate when you’re trying to deal with a large program like this.”

The first step of the federal upgrade should be ready by April 1: Healthcare.gov, where people sign up for insurance in 36 states, will start showing prices that reflect the new policy. For more than five million Americans with lower incomes, health plans will be available for no monthly premium. For others who earn more, new discounts could be worth hundreds of dollars a month.

But getting those lower prices will require work: Americans who already have Obamacare insurance will have to go back to the website where they bought their insurance; make sure they don’t want to switch plans; and certify that they want the new, expanded tax credits. Those who fail to do this will keep paying their current price. They should eventually receive the additional funds as a large refund with their 2021 taxes next spring.

People who have bought their own insurance elsewhere will need to cancel their current plan and switch to an eligible one.

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