Exchanges to buy insurance open

Today is first for purchases


There’s only one chance to make a first impression, so will the online health insurance exchanges, tent-pole to President Obama’s 2010 Affordable Care Act, work as advertised as they go live this morning?

Or will the various glitches, bugs, and delays that have plagued the construction of the exchanges — one of the largest information technology projects in modern times — doom the launch?

“I think it’s understandable [that with] something this big and complex, there may be some glitches to work through,” said Bill England, Pennsylvania director for Enroll America, the Obama-aligned nonprofit group whose goal is to convince the uninsured to sign up for health coverage, as is now required by federal law.

Those potential glitches are “part of our messaging,” Mr. England said on Monday. “It begins on Oct. 1, and we reassure people that they have six months” to sign up for a plan.

“This is just the starting line. This is not the race.”

For all the build-up to today’s launch, Oct. 1 doesn’t mark any sort of consumer deadline. It’s a curtain-raiser to what is essentially a six-month open-enrollment period.

The uninsured can spend the next six months shopping for plans online and calculating potential subsidies before pulling the trigger; those hoping for coverage by Jan. 1 must buy a policy by Dec. 15.

Still, many — perhaps millions — will test-drive the sites today, even if they don’t buy a policy immediately. At that point, glitches could surface, along with these acknowledged delays:

  • Several of the state-operated exchanges, including those in Oregon, Colorado, and the District of Columbia, have said certain enrollment functions won’t be ready for a few more weeks.
  • The Web function that was supposed to allow small businesses to shop for and buy insurance for employees will have to wait until November to complete the sign-up process. That could affect 2 million potential enrollees.
  • The Spanish-language side of the federally operated exchanges isn’t ready either, according to the Associated Press. An estimated 10 million Latinos — 4 million of whom speak Spanish exclusively or primarily — are expected to be eligible for subsidized policies or Medicaid policies under the Affordable Care Act.
  • The federal exchange site,, is supposed to evaluate income and family size to determine if applicants are eligible for Medicaid coverage, rather than a private policy purchased through the exchanges. At that point, the exchange is supposed to transfer applications to a state’s welfare department. But that functionality won’t be available until November.
  • Lastly, according to the Wall Street Journal, the software meant to determine whether shoppers get any tax subsidy wasn’t returning accurate results.

The U.S. Department of Health and Human Services is overseeing all or part of the exchanges in 36 states. The rest of the states have built their own Web sites.

Day One issues might be more than just a cosmetic issue for the Obama Administration.

Republicans, particularly those in the House, are rooting for the failure of the online exchanges in hopes that an early flop will give them ammunition in their attempt to delay, defund, or otherwise derail the landmark health-care law, whose key provision — an “individual mandate” requiring most Americans to obtain health insurance or face a fine — was upheld as constitutional by the U.S. Supreme Court last year.

But Mr. Obama’s allies continued to sell the exchanges Monday and during the weekend.

In an opinion piece that ran in several newspapers, Vice President Joe Biden criticized the House Republicans who “are going to demonize [health-care reform], run against it, do what they can to sabotage it.”

Health and Human Services officials are urging patience and are reminding potential shoppers that if the Web experience is unsatisfactory, they also can sign up by telephone by calling 1-800-318-2596 toll free or with an insurance agent.

The federal government says its phone centers will be heavily staffed, and, on the Web side, “armies of information technology specialists tested and retested the complex interfaces and communication links needed to make the exchanges functional” during the weekend, according to Reuters news.

The federal government and most analysts expect that the Web site and phone lines will be most heavily trafficked in November and December, after consumers have spent a few months doing some comparison shopping.

About 7 million people are expected to obtain policies through the exchanges, while 8 million more could receive coverage through an enlarged Medicaid program.

The Block News Alliance consists of The Blade and the Pittsburgh Post-Gazette. Bill Toland is a reporter for the Post-Gazette.

Contact Bill Toland at: or 412-263-2625.