Obamacare's Health Exchanges: "full of issues, bugs and technological challenges"



President Obama is in California today. He's giving a speech touting the state's experience with the law so far as proof the Obamacare can and will work.

Well, it'll work…except that the law's insurance exchanges, which are designed to facilitate the bulk of the law's coverage expansion, may not be fully operational, and will probably be kind of glitchy, when they go online later this year. The Wall Street Journal reports:

Teams of technology experts are racing to finish building government websites that will allow people to shop and sign up for health insurance this October. People involved in the effort say to expect some problems, at least initially.

…"Something will be up and running on Oct. 1," when open enrollment starts, said Dan Schuyler, a director at the consulting firm Leavitt Partners and a former director of technology for Utah's health-insurance exchange. "It will be full of issues, bugs and technological challenges," he added.

The biggest problem on the tech side, it seems, is coordinating all of the different databases required to determine eligibility for insurance subsidies and Medicaid. That's not something that's ever really been done before. And Medicaid in particular is a challenge because each state's Medicaid program is unique.

Then there's the user experience, which may not be quite as simple as people have been led to expect:

"This is less likely to be a [travel-booking] experience," said Bruce Caswell, president and general manager of health services at Maximus Inc. "It will be more like applying for a mortgage online." Maximus, based in Reston, Va., is involved in building out Maryland's and Minnesota's exchanges and running call centers in other states such as Connecticut and New York.

Mr. Caswell said some people should be able to easily sign up online, while more "complicated" family situations—such as when a woman is pregnant and eligible for Medicaid, but her husband isn't—might have to be handled manually.

Of course, regardless of whether the exchanges are functional, there's still the question of whether enough lower-income individuals will actually sign up for the law. And there's some reason to suspect that some of them may not. Certainly there doesn't seem to be much enthusiasm for the law right now. The latest NBC/Wall Street Journal poll on the law, released Wednesday night, shows that 49 percent of the public opposes the law, and just 37 percent supports it. That's the highest opposition level since the poll started asking about the law. Meanwhile, 38 percent of respondents think the law will make them worse off—more than at any time since President Obama signed the law in 2010. 

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  1. Teams of technology experts are racing to finish building government websites

    By “racing” they mean “sitting around and waiting for a committee to approve every minor micromanaged detail.”

    1. The Government IT Motto “Hurry up and wait”, also used in other branches.

    2. Since the committees finally approved fonts and button placements in April, and will now wonder why the developers want all these stupid decisions about data and logging instead of just making the goddamn thing work like the wireframe.

      1. I remember the day I quit caring about my job. It was when I was told to undo a fix to a known bug because it had not been explicitly approved by the committee in charge. Since then I couldn’t give a shit less. Fuck ’em.

        1. I hate working with non-technical people. Spend 90% of the planning time fighting about color schemes, fonts, and button placement, dodge the actually important decisions, then wonder why their project is a gigantic clusterfuck.

          1. When I first started working here it was fun. We got a lot done, we responded to the customer’s needs, fixes and enhancements were turned around quickly, but then it all came to a screeching halt. Someone complained that we were getting too much done, “buccaneers” was the term they used, so now all work down to fixing misspelled words must go through a committee. That and we’re not allowed to interact with the customer directly. I post on Reason because I have nothing else to do.

            1. That and we’re not allowed to interact with the customer directly.

              “We’re not allowed in the house”. I feel your pain. I’ve been there. They let me walk around unsupervised all the time, now. Its kind of exhilirating.

              1. They seem to think that not allowing developers to speak with users will produce a better product.

            2. me too.

              I’m here and in my retirement excel. I only have to show up 1735 more times. That’s 339 mondays, 356 tuesdays, etc.

              Come to think of it, vacation starts in 2 hours. See you all June 17!

          2. “D-D-D-D-Don’t quote me regulations. I co-chaired the committee that reviewed the recommendation to revise the color of the book that regulation’s in… We kept it grey!”

  2. Hey Pete, I was just reading about the new fun and exciting time bomb set to explode from Obamacare in 2014 -“States can unload their retirees’ health insurance responsibilities on Affordable Care Act exchanges” ( http://www.usatoday.com/story/…..n/2394187/ ) Is this for real?

    1. Well, we all knew O was going to bail out CA and IL one way or the other. Guess they’ve picked this way.

      Looks like CA won’t be going bankrupt anytime soon after all.

      Thanks for the link, Tman.

    2. Gotta do something when Medicaid eats the entire state budget.

    3. If you haven’t seen David Walker speak, you should definitely him out.

  3. Why does every known photo of crone Sebelius look like some sort of cut-rate Bond villainess, in drag…?

    1. Why is the HHS Secretary smoking?

    2. I bet you won’t look half that good when you’re 107.

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