More than 50 new health insurance exchange websites — luring more than 30 million new users — will go live Oct. 1.
So what could possibly go wrong?
Though the Patient Protection and Affordable Care Act remains the subject of endless debate, some experts warn technology could be the law’s early downfall.
At this summer’s Colorado State Association of Health Underwriters’ annual symposium in Denver, one speaker warned the exchange launch could be the “next Y2K” — millions of Americans logging on in October might overwhelm the exchanges.
That’s a dire warning, certainly, but experts do warn of bugs, glitches and other technical problems beginning Oct. 1, when open enrollment in the exchanges begins.
See also: PPACA data hub testing incomplete
“There will be problems,” says Patrick Riley, a health senior industry analyst at Frost & Sullivan in Mountain View, Calif. “I build websites for a living, and every website has had problems. There’s no question [the exchanges] will. The question is: How are they going to handle it?”
Some sites already have experienced hiccups in advance of open enrollment.
Connect for Health Colorado’s site wasn’t working properly back in May, when the state wanted to offer the public an easy way to check new health policy prices. And that was only for casual viewing.
Officials in other states admit not everything will be ready on time as initially planned, saying it will take months more to add some of the bells and whistles. Concerns about security and capacity are foremost.
Earlier this spring, President Obama even predicted “glitches and bumps” when enrollment opens.
“I don’t think it’s cause for concern or panic,” says Rosemarie Nelson, a principal consultant at MGMA Healthcare Consulting Group in Jamesville, N.Y. “But that being said, we know that with technology, anything that can possibly go wrong will go wrong.”
‘Months behind schedule’
The state exchanges are a main component of PPACA. The law’s success hinges on the number of people who enroll in health coverage through the exchanges.
When the Obama administration this summer delayed other key parts of PPACA — including the employer mandate penalty — some became convinced an announcement regarding the exchanges was imminent. But the administration insisted they would launch on time.
It’s a tall order.
This summer, the Government Accountability Office pointed to challenges in opening the federal exchanges on time, underscoring the challenges facing the administration the last remaining months.
Riley says the exchange launch — built on the federal data hub — is one of the largest undertakings of its kind for the government.
“The federal government is running 33 of the exchanges. People can’t get their heads around how big this is,” Riley says. “No one knows if this is going to work.”
Just recently, a report from the Inspector General’s Office at Health and Human Services spelled out the concerns. In short, the federal health insurance exchange network is “months behind” on tests related to protecting privacy.
Much of the report focused on the federal data hub, a single point where new exchanges can access information on who qualifies for what programs.
“Several critical tasks remain to be completed in a short period of time,” the IG report stated.
The administration insisted that was old news — the report was from May, but only released in August.
HHS Secretary Kathleen Sebelius insisted the exchanges will open on time, while other officials said they’ve made significant progress solving the initial problems of the exchange.
Despite the government’s reassurance, personal security remains a concern, industry insiders say.
Data security is paramount, as applicants will be required to submit a variety of sensitive details, including name, birth date, address and Social Security number, in the process of obtaining insurance. Some worry hackers could easily access the sensitive information of millions of Americans.
As the report summarized: “Effective security controls are necessary to protect the confidentiality, integrity and availability of a system and its information.”
With the launch just weeks away, it’s an incredibly tight deadline.
States and major health insurance players haven’t had time to test the efficiency of their systems, leaving even less time to work out all the kinks.
But Riley says it’s impossible to fix all the problems without postponing the exchange enrollments altogether.
“It’s software, so you never have enough time to do it,” Riley says. “[They’re] going to have problems, but [they] need to launch this.”
One challenge to opening health insurance exchanges is that networks that have never communicated with one another before will have to get on friendlier terms. The exchange websites have to interface with the IRS, state Medicaid systems and dozens of different insurance companies.
Then there’s coordinating all the different databases required to determine eligibility for insurance subsidies and Medicaid.
For example, if someone’s income qualifies him for Medicaid, software will divert him from the exchange to that specific system.