Exchange open enrollment will present tech challenges


Although health insurance exchanges will indeed begin operating by October's open enrollment deadline, many technology experts are expecting the online marketplaces to present problems initially.

"Something will be up and running on Oct. 1," Dan Schuyler, a director at consulting firm Leavitt Partners, told the Wall Street Journal. "It will be full of issues, bugs and technological challenges."

The problem is that exchanges require computer programs to communicate with several U.S. government databases, including the Internal Revenue Service, to determine whether applicants are U.S. citizens or legal residents and whether they're eligible for subsidies. Plus the online marketplaces must connect with systems for state Medicaid programs and insurers that are offering plans–all within about 30 minutes of a consumer applying to enroll in the exchange.

"It's a lot of work that's going on in a very short period of time," Jim Wadleigh, chief information officer of Connecticut's exchange, told the WSJ. Plus, he added, the Obama administration has been releasing new rules that amend different aspects of the exchange process, including updating the consumer application, which means programmers have to redesign the exchange website.

Even President Barack Obama conceded last month that "glitches and bumps" will likely accompany the launch of the exchanges before they ultimately lead to lower healthcare costs, FierceHealthPayer previously reported.

Insurers that will be selling plans on the exchanges are worried too. "We are going to have a very limited window for testing and working out some of the kinks," said Scott Keefer, a vice president at Blue Cross and Blue Shield of Minnesota.

What's more, the exchanges won't be recreating experiences provided by online traveling booking sites like Travelocity or Expedia, as some in the industry have predicted. "This is less likely to be a [travel-booking] experience," said Bruce Caswell, president and general manager of health services at Maximus, which is helping states build their exchanges. "It will be more like applying for a mortgage online."

That's partly because "complicated" family situations, such as when a woman is pregnant and eligible for Medicaid, but her husband isn't, likely will still have to be handled manually, he said.

To learn more:
- read the Wall Street Journal article

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