Obamacare's State Run Exchanges Are Working Better. But That Doesn't Mean They're Trouble Free

Healthcare.govHealthcare.govWe’ve heard a lot about how the minority of states running their own health insurance exchanges are faring much better than the 36 states in which the federal government is in charge. That’s definitely true. But better is a relative term, and any quasi-functional system is going to look good compared to the disaster that is the federal exchange system.

In a report on how state-run exchanges were outperforming their federal counterparts, for example, The New York Times recently reported that New York’s state-run exchange had announced “that it had signed up more than 40,000 people who applied for insurance and were found eligible.”

“This fast pace of sign-ups shows that New York State’s exchange is working smoothly with an overwhelming response from New Yorkers eager to get access to low-cost health insurance,” Donna Frescatore, the state exchange director, told the Times.

But here’s the thing: 40,000 people have applied through the state exchange and been told whether or not they qualify for subsidies. But that’s not how many people have actually enrolled. Those people may not have even selected a specific plan yet. 

Moreover, it appears that no one has fully enrolled so far. According to a story in this morning's New York Daily News, none of the applications filed through the system have actually been transmitted to insurers yet. And health insurers selling plans in the state are also worried that the plan information being displayed on the exchanges isn’t correct: 

But the state has repeatedly delayed electronically transmitting those users’ data to insurers offering health plans.

The department, which held off in order to verify the accuracy of the information users submitted, said it would transfer the first batch of enrollees’ data — which includes thousands of transactions — as early as Friday night.

Meanwhile, insurers were worried that the state website had incorrect information on details of plans that are available. “We have heard from some plans that some of the information they thought was going to be there isn’t showing up,” said Leslie Moran, a spokeswoman for the New York Health Plan Association.

New York isn’t the only state-run exchange having trouble. Maryland—the state that President Obama specifically praised as being ahead of the curve on exchange implmentation a week before launch—was still “plagued by technical problems” last week, and state officials said at the time that it could be six weeks before it’s all fixed, according to a The Baltimore Sun report. Some improvements appear to have been made, but enrollment is still slow going. By the end of last week, just 2,400 people had actually enrolled in insurance through the state system. Hawaii’s system took two weeks to get up and running. Oregon’s health exchange, which delayed online functionality before October 1, still can’t enroll people in private plans at all. That functionality is still a minimum of two weeks away

Several of the state-run exchanges do appear to be working better; Kentucky and Washington state in particular seem to be sailing fairly smoothly at this point. But given how much less attention is being paid to the state-run exchanges, and given the revelation that New York hasn’t actually transmitted any of its applications yet at all, it does make me wonder whether or not we’ll eventually find out that some of the supposedly better-run state-based exchanges aren’t running quite as smoothly as many people initially thought.  

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  • Fist of Etiquette||

    But that’s not how many people have actually enrolled. Those people may not have even selected a specific plan yet.

    We're using the Chad Henderson scale here.

  • R C Dean||

    Nicely done, Suderman. The only data point that matters for evaluating (initial) success of the HIEs is the one data point the various flaks, toadies, hangers-on, and sycophants are doing their damnedest to obfuscate:

    How many policies have been sold through the exchanges?

    To evaluate that data point, you need further data points:

    How many of those were sold to people who were previously uninsured?

    How many lives are covered by those policies?

    What are the demographics and actuarial viability of the HIE pool? Is the HIE viable? Is it poisoning (or enhealthening) the pre-existing individual policy market?

  • playa manhattan||

    I've had it up to here with your facts, numbers, and logic.

  • LarryA||

    The "interesting" takeaway is that enrolling people is the simple part, compared to actually providing care.

    We are about to live in interesting times.

  • Hyperion||

    Moreover, it appears that no one has fully enrolled so far

    But, we were told that without the redemption of Obamacare, millions of children will die in the streets, each day, because of no health insurance.

    Why is Obama allowing millions of children to die in the streets every day? Why can't the smartest man in the world fix this system?

  • Almanian!||

    It's the intransigence and obstructionism of the teathuglihadists, Hyperion.

    If not for Our Lord and Savior Barack Obama's efforts, MOAR childrunz would be dying. As it is, millions make it - because of HIM. Because of Our Lord and Savior, Barack Obama. Praise His name!

    And CURSE ths evil teathuglihadist racist homophobe white child killers!

  • Brian||

    Peace be with him!

  • Adam330||

    "We have heard from some plans that some of the information they thought was going to be there isn’t showing up...."

    This is going to be a fun legal issue. What happens when the insured thinks the insurance has one set of terms based on the state's website and the insurance company thinks otherwise based on its plan documents and what it told the state to put on the website? I suspect a bad outcome for the insurance company the first time it happens, and reactions from insurance companies ranging from refusing to list on the exchange to jacking premiums to account for the state's blunders.

  • ||

    The possibilities for incredible fuckups is huge here. Based on the sheer incompetence of this rollout, let's say that they somehow get it working enough that people can actually buy policies. How many of those policies are going to be wrong? How many are going to have been sold to people they weren't supposed to be (maybe the person wasn't eligible for that particular plan or something)? What happens when the insured person starts making claims? What happens?

  • Neoliberal Kochtopus||

    Please, Episiarch, any failures of our Great Healthcare Five Year Plan can be lain squarely at the feet of capitalist running dogs, hoarders, wreckers, and other counterrevolutionary elements.

    But seriously, the insurance company will try to drop that person for fraud. The person will rightly point out the government exchange let them do it. The government will blame the insurance company for its greed, and then we'll get single payer.

  • ||

    Sounds about right. All according to plan!

  • Red Rocks Rockin||

    Whoever that poor girl on the opening page is, she's going to end up being the face of this clusterfuck forever.

    The irony is that the pics they're using probably were just a bunch of random shots taken by a marketing firm and then sold to the government for use on the site.

  • All-Seeing Monocle||

    Does Ocare cover nostril reduction?

  • playa manhattan||

    Henry Waxman's daughter?

  • All-Seeing Monocle||

    Also, whoever that poor girl is, I'm guessing there's currently a market for a picture of her making an "oh shiiiiiit" face.

  • Neoliberal Kochtopus||

    Thank god we have our Emmanuel Goldstein.

  • ||

    Is it just me, or does the expression on her face look like she's kinda laughing at you?

    At first, I thought she was just smiling about how happy she was to have ObamaCare. But now it looks a little like she's secretly amused.

    Like she's really thinking "Lol! I don't actually have insurance suckers!" or "Lol! You thought this web page was going to work? Ha!"

  • CE||

    Yeah, I thought she's thinking either:

    A) "Obama is the greatest president evah!"

    B) "I'm a Republican. I knew this was going to FAIL."

    or

    C) "I would kill my agent, but I'm moving to Mexico anyway, for the higher quality, lower cost health care."

  • Sevo||

    It's the 21st day of the 'roll-out'; do we have one single confirmed purchase of insurance?

  • R C Dean||

    Depends, in part, on when the first premium has to be paid. They may not require it until just before the coverage period starts, or even give a grace period.

    Another data point we will never see:

    How many HIE policies are cancelled for non-payment of premiums? How does that compare with cancellation of individual policies pre-HIE?

  • Ayn Random Variation||

    This reminds me of the Seinfeld episode where he made a reservation for a rental car, but when he showed up at the place they didn't have the car. And he goes on a rant about how anybody can take a reservation, but the hard part is actually having the car.

  • Neoliberal Kochtopus||

    Probably the best Seinfeld bit ever.

    Car Rental Assistant: I think I know why we have reservations.

    Jerry: I don't think you do. You see, you know how to TAKE the reservation, you just don't know how to HOLD the reservation. And that's really the most important part of the reservation: the holding. Anybody can just take them. (*grabs invisible pieces of paper out of the air*)

  • CE||

    Happened to me this summer. I said, wait a minute, I had a reservation. Your online form even made me fill out which flight I was taking, and my flight was on time. So you gave my reserved car to someone else anyway?

    Then when I returned it a day early, they charged me extra. I reserved it for a week, because it was cheaper than the 6-day rate. I asked, how does it hurt you that I've returned the car a day early? You rent them out to people even without reservations, so you can make MORE money if you have it an extra day.

  • Yancey Ward||

    The most hilarious thing is Frescatore of NY. She can tell you that 150,000 have applied, but she can't pin down a more specific value for the "enrolled" than by saying "thousands". On top that, it appears the meaning of "enrolled" is something other than "arranged to buy a specific policy" since we now know NY has actually sent nothing yet to the insurers. The lying from the public officials going on here is epic.

    I can pretty much guarantee you the numbers from Washington and Kentucky are being inflated using the same methods of obfuscation.

  • XM||

    If most people who enrolled are white:

    "That's good, it's about time White people pay health insurance for the minorities"

    If most people who enrolled are not white:

    "ACA is a huge hit among minorities! Diversity FTW"

    If most people who enrolled are sick folks with Preexisting condition:

    "Look at all those sick people who now have health insurance! Success!"

    If most people who enrolled are young healthy kids:

    "The young invincibles are making sure ACA doesn't collapse!"

    See, Obama wins.

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