Launch of healthcare exchange plagued by problems
Published: Monday, October 14, 2013
Updated: Monday, October 14, 2013 22:10
The state and federal health care exchanges opened almost two weeks ago on Oct. 1, a fact that may have been overshadowed by the start of a partial government shutdown on the same day. What should have been the biggest story around took a back seat to the fiscal crisis in Washington. I think that’s too bad. Although the dysfunction in Washington is a huge problem, it pales in comparison to the dysfunction of HealthCare.gov. The site is poorly designed and poorly coded, and I don’t think there is any excuse.
I mention the site’s poor design because the really tricky part of exchanges is behind the curtains. Information verification is never an easy task. Retrieving and sending information from a myriad of federal databases was never going to go down without a hitch. The exchanges have to verify your income, age, whether or not you can receive insurance from an employer and your legal residence just to calculate the federal subsidies that you are eligible for. The design of the website likely exacerbated these problems, but more on that later. The surface problems can, and will, be fixed over time, but if this complex network that connects the exchanges to federal databases and insurers does not work then the law will not work. Some experts worry that if the back end isn’t functioning it could take months or years to fix.
It was an inauspicious start to a highly-contested law. The federal health care exchange flopped and in a big way, and on a national stage. The initial problem was dismissed as a traffic problem. Some proponents of the law have even taken to touting the higher than expected traffic as proof, both of the law’s popularity and success. The problem is the website should have been built to handle more traffic. The administration should have predicted an influx of hits on the first day. This law has been the subject of so much controversy that most anyone with a horse in the race probably logged on just to check things out. I know I did. It’s also important to note that the traffic problem was made worse by poor design. The website won’t let you shop around without first making an account. This creates a choking point, that combined with the problems mentioned above was the source of the exchange’s problems. People shouldn’t have had to create an account on the first day. Why not let people enter in their information income, age, etc. and let people see what they are likely to pay without information verification. This would have certainly smoothed the exchange’s launch. People shouldn’t have been setting up accounts, and they definitely shouldn’t have been purchasing insurance on day one. The insurance wouldn’t even kick in until January. So why make shopping so difficult? That is unless you don’t want your prices scaring people away.
Bottom line, people should be concerned. If it’s too difficult for people to sign up, then young, healthy individuals who don’t need insurance will be less likely to join. This would be a major problem because people with pre-existing conditions, many of whom are going to be able to get affordable coverage for the first time in a long time, will find a way to sign up. They will log in as many times as it takes, they will register by phone if they have to, or go straight to the insurance companies. This would drive up premiums. If that happens it would be hard to imagine the Affordable Care Act remaining law.