ObamaCare's state based health insurance exchanges are already facing serious political resistance: Several Republican governors, including Florida's Rick Scott and Louisiana's Bobby Jindal, have said they won't create exchanges; others, like New Jersey Gov. Chris Christie, have put exchange creation on hold until the Supreme Court rules.
But even states that have agreed to create exchanges are running into sizable technical hurdles building the required IT infrastructure, reports Politico:
Even states that are solidly committed to pursuing an exchange are facing major logistical challenges in building the computer systems that will be able to handle enrollment when exchanges open for business in 2014.
That's largely because the system that will actually connect people to the right coverage will have to "talk" to many other systems, and the systems don't use a common language. This includes a yet-to-be built federal "data hub" with tax and citizenship info, the enrollment systems of multiple private insurers selling exchange plans and — hardest of all — state Medicaid enrollment systems, many of which are not yet fully computerized.
Even if all the states that have taken the biggest steps to launch exchanges — fewer than 20 at the moment — were charging full speed ahead, there's a lot of concern that they'll have to switch to a "partnership" exchange model, with the federal Department of Health and Human Services running key functions. That's because their IT systems could fail final tests in the months before the exchanges open in 2014. And that would mean losing some of the ability to customize the enrollment process for a state's needs.
I tend to think that in the midst of all the political controversy surrounding the law, people have underestimated the logistical challenges of implementing ObamaCare. These sorts of technical concerns haven't garned the same level of attention as, say, they Supreme Court challenge to the law, but they've been around for a while, and they're fairly serious: In "Rogue States," my October 2010 feature looking at state implementation of the law, I noted early worries about whether the technical requirements for the exchanges would actually be feasible. Nearly two years later, we have more details on the particular challenges states attempting to build exchanges are actually facing, but we don't have a lot of answers about how or when they'll fix them—or, for that matter, any real assurance that they will.