He rejected the idea of a flashy downtown news conference that morning. He postponed a series of ads meant to drive customers to its Web site, coveroregon.com. In fact, Mr. King is not even allowing people to sign up for health coverage online without assistance at first; they will have to go through an insurance agent or a community group until at least mid-October.
Tuesday is the long-awaited kickoff of President Obama’s signature health care law, when millions of Americans can start signing up for new insurance options. Yet across the country, officials are issuing warnings that despite fevered efforts, their new insurance exchanges — online markets where people can shop for health plans and see if they qualify for federal subsidies — will not be fully operational for weeks or even months.
Last week, the District of Columbia’s exchange announced that it would not immediately be able to determine online whether people qualify for Medicaid, which about half the states are expanding under the law, or for a federal subsidy to help cover the cost of private coverage. In Colorado, for the first month, people who want to know if they are eligible for a subsidy will have to call a customer service line.
In Nevada, home to a large Hispanic population, a Spanish-language version of the exchange Web site will not be ready until mid-November. And in Maryland, small businesses will not be able to buy insurance for their employees through the state exchange until January. Federally run exchanges are having similar problems.
Many of the 16 directors of state-run exchanges are describing October as a “soft launch” period, when Americans can start exploring their coverage options — but on Web sites that may be incomplete, vulnerable to glitches and perhaps not ready for an onslaught of customers.
“I have no idea what this thing’s going to look like on Oct. 1,” Mr. King said one afternoon last week as dozens of tense-looking programmers, scattered through the exchange offices outside Portland, rushed to finish testing and fix problems. “We could crash and burn and have to close it down.”
The outcome could hardly be more important for Mr. Obama. With Republicans threatening to shut down the government unless Democrats agree to delay the law for a year, even small problems with the exchanges could be powerful fodder for the law’s opponents.
In an indication of the difficulty of the job, some of the states with delays, like Oregon and Maryland, have been preparing for many months and have political leaders who strongly support the law.
“It makes you wonder about the exchanges that actually have been at this a shorter period of time,” said Jon Kingsdale, a managing director at Wakely Consulting Group, who is advising several state-run exchanges. “Do they even know what their problems are?”
The federal government, which will operate all or part of the exchanges in more than 30 states that declined to create their own, mostly because of political opposition to the law, is having readiness problems of its own. In one example, the Obama administration said on Thursday that small businesses would not be able to buy coverage online through federally run exchanges until November.
Although the exchanges have been able to tap billions of federal start-up dollars and hire companies like Accenture, Oracle and Xerox to help with the work, their task has been highly complex and their time frame tight.
The Web portals for the exchanges have to be able to share information in real time with insurance companies, state agencies and the federal government, which has built a “data hub” through which it can verify the income and citizenship of people applying for subsidies or Medicaid. Each portal has to undergo rigorous testing to ensure, for example, that data will flow properly, that the portal is secure and that it can handle heavy volume. Much of the testing is still going on.
Article source: http://www.nytimes.com/2013/09/30/us/as-opening-day-nears-insurance-exchanges-scramble-to-prepare.html?partner=rss&emc=rss
