Whitehouse.govWill Obamacare’s federally run
health insurance exchanges be ready on time? In a report released
today, the Government Accountability Office has weighed in on the
question, and its answer is…maybe? But the federal watchdog can’t
say for sure—and federal officials will face additional challenges
between now and October, when the exchanges are scheduled to open
Under Obamacare, each state will have its own health insurance
exchange, and 34 of those exchanges will be run by the federal
government. (States will assist with some of the work in 14
states.) Those exchanges are supposed to start accepting enrollees
on October 1 of this year, but for the last few months reports have
suggested that federal officials may be having a difficult time
with the implementation effort, and in particular with the database
technology that is supposed to make up the heart of the exchanges.
Health and Human Services representatives have continued to insist
that the exchanges will be up and ready on time, and they still do
today. But the GAO’s report isn’t exactly confidence inspiring.
“Much progress has been made,” the report says, “but much
remains to be accomplished within a relatively short amount of
time.” Medicare officials have a timeline in place that they say
will allow them to open the exchanges on schedule. But that’s only
if they can stick to the timeline. The agency has missed multiple
deadlines so far, the GAO report says, and that could be a problem:
“While the missed interim deadlines may not affect implementation,
additional missed deadlines closer to the start of enrollment could
Meanwhile, the federal government is still relying on states to
do some of the work, but the GAO report found that “many state
activities remained to be completed and some were behind schedule.”
Even with the contingency plans that federal health officials say
they are developing, GAO concludes that it’s tough to say whether
the federal exchanges will be ready on time. "Whether CMS’s
contingency planning will assure the timely and
smooth implementation of the exchanges by October 2013 cannot
yet be determined," the report says.
There’s plenty that’s not finished on the federal side too.
Federal health officials have “many key activities remaining to be
completed across the core exchange functions—eligibility and
enrollment, including development and implementation of the data
hub; program management; and consumer assistance.” That’s a lot to
not have finished with just a few months to go, especially since
GAO reports that federal officials are already behind schedule on
some of those activities, like consumer assistance planning.
Some of the key technological features of the exchanges haven’t
been tested yet: Functionality intended to offer real-time
verification of income, citizenship, and eligibility for insurance
subsidies hasn’t happened so far, and the federal government told
GAO it still needs to complete additional steps in order to do so.
The plan is to have those steps completed by July. But, as
previously noted, sticking to deadlines has proven difficult in the
In other words, there’s still a lot of work to be done, and the
conclusion one ought to draw from the GAO report is that it’s not
entirely clear that federal officials can complete it all on
Nor is the GAO the only organization reporting that government
officials setting up exchanges have a rocky road ahead of them. The
Robert Wood Johnson Foundation published a
report this month looking at exchange implementation efforts in
three states: Alabama, Virginia, and Michigan. And it too found a
variety of struggles with the process.