Photo credit: GovWin a Deltek Network / Foter.com / CC BY-NDPhoto credit: GovWin a Deltek Network / Foter.com / CC BY-NDWhat should we expect from ObamaCare’s health insurance exchanges when they go online later this year? Not perfection, that’s for sure.

“It’s only prudent to not assume everything is going to work perfectly on day one,” Gary Cohen, an official with the Centers for Medicare and Medicaid Services (CMS) who is heading up the federal government’s exchange implementation, said at a policy meeting put on by the insurance industry. “As we move closer to October, my hopes are the range of things that could go wrong gets narrower and narrower,” he said. But, he added, “everyone recognizes that day one will not be perfect.”

Congressional Quarterly, which first reported Cohen’s remarks, also quotes Henry Chao, the CMS official in charge of the exchange technology, saying that with less than 200 days before the exchanges open, he’s “pretty nervous.” At this point, Chao officials are just hoping that what they build is mostly functional. “The time for debating about the size of the text on the screen, or the color, or is it a world-class user experience, that’s what we used to talk about two years ago,” Chao is reported to have said. “Let’s just make sure it’s not a third-world experience.” 

Neither Cohen nor Chao provided specifics about what they thought might go wrong. But Cohen did suggest that some of the state-based exchanges might not live up to expectations. “I think there is some possibility that the type of exchange may be different than what we’re looking at today,” he said. Along those lines, Cohen seemed to suggest that some of the state-run exchanges might not be ready on time — and the federal government would have to step in and run those exchanges, at least at first. CQ reports that Cohen told reporters that he “hopes” the state-run exchanges will all be ready on time, but there is “contingency planning” currently going on for opening-day problems in case problems arise.

Cohen and Chao aren’t the only ones who seem worried about the law’s implementation. Last month, a group of Democratic Senators met with Health and Human Services Secretary Kathleen Sebelius to note their concerns about the implementation process, according to The Hill. Separately, Democratic Senator Max Baucus, who played a key role in drafting the law, told Cohen that he was worried about progress implementation of the law’s complex technical requirements, which require multiple state and federal databases to communicate seamlessly.

(Via Avik Roy.)