Some perspective on malfunctioning ACA exchanges

It is fairly pathetic that they may not be up and running in proper form by October 1, but it is not the main issue either.  Dan Diamond has some good remarks, here are two excerpts:

Overwhelmingly, the Americans who will be shopping through the exchanges this fall are the ones who have pined for this moment for months, if not years: The chronically ill who wanted coverage but couldn’t get it, or the low-income Americans who couldn’t afford it. They likely won’t be deterred by a few software glitches.

That is a very good point, though I wonder if it will contribute to insurance company enthusiasm in the early stages of actual implementation.  Dan also notes:

There already were a mix of offline ways to purchase coverage through the exchanges, whether through call centers or in person; the AP notes that 30% of applicants were expected to use paper.

But software delays may spur additional solutions, too. Oregon, for example, will rely on insurance brokers to help state residents obtain coverage until the state’s exchange website is ready to go.

And an enormous number of stakeholders want the exchanges to be successful, from insurers that are hoping to see new business to hospitals that want to lower their uncompensated care costs. Basically, CMS can raise a virtual volunteer army if necessary.

Meanwhile, the enrollment period runs through March 31. There’s no “early bird special” as Dave Morgan, a California employee benefits adviser, pointed out on Twitter; premium prices for 2014 will be the same whether you’re purchasing coverage on Oct. 1 or Dec. 15.

Dan adds, however:

All bets are off if the software problem isn’t fixed in a few days or weeks. The exchanges were touted with the promise that they’d be like Orbitz or Amazon, just for buying health coverage.

So I still say all bets are off.

Coming from other directions, Timothy Taylor offers some useful perspectives on ACA, which now it seems will cover only about 40% of the previously uninsured.


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