By October 1, most states will be ready to operate their health insurance exchanges (HIE). Experts predict that nearly 30 million Americans will become insured thanks to the Affordable Care Act.
What happens when 30 million people demand something all at once? Clogged phone lines and overcrowded networks. Dan Schuyler, a director at Leavitt Partners, is the former technology director for Utah's health insurance exchange.
"Something will be up and running by Oct. 1," when enrollment opens, Schuyler predicted. "It will be full of issues, bugs and technological challenges."
Some health insurance players, like Scott Keefer of Minnesota Blue Cross Blue Shield, say they've been given limited time to test the efficacy of their systems. Officials, according to Keefer, will have "a very limited window for testing and working out some of the kinks."
Technically, states don't have to go online to offer consumer policies until January 2014, and they don't have to offer policies for small business owners until 2015. However, enrollment opens Oct. 1, and many states are competing to see who can be the best. Connecticut, for example, will open both of its health insurance exchanges on Oct. 1.
One challenge to opening health insurance exchanges is that networks which have never communicated with one another before will have to get on friendlier terms. HIE websites have to interface with the IRS, state Medicaid systems and dozens of different insurance companies.
Another challenge for developers is that the rules keep changing. For example, the federal government recently cut the length of the consumer application. That reduction is good news for consumers, but it's a drag for developers who have to redesign HIE Web pages.
The federalist healthcare approach set up by the Affordable Care Act is a blessing and a curse. On one hand, states have wide latitude in how they design their programs, if they choose to run their HIEs on their own. They can choose board members, governance structure and health plan standards that exceed federal requirements. Opening the process to innovation taps the brains of more players to develop more innovative solutions for Americans.
On the other hand, all 50 systems have to play nicely with one another. Until the solutions are running smoothly, expect some "teachable moments."
Edited by
Alisen Downey
