Week Two: Are the health exchanges doing any better?

Credit: Mike Licht, via Flickr under creative commons.

It’s been just about two weeks since the Affordable Care Act’s state health exchanges, or exchanges opened for business. Their first week was pretty rough. Despite the crush of millions of people looking to sign up for health insurance, many could not because of technical issues with the exchange websites.

Federal health exchange

The worst offender was by far the Federal Health Insurance Exchange, which is operating in the 36 states that chose not to create their exchanges under the ACA. From hour one, the Federal exchange was malfunctioning, and now 11 days later the site is still largely inoperable.

What the exact glitches are varies, but most people aren’t even able to get past the section where they create a profile to use the exchange. This means that most of the system has yet to be tested under the real-world stress that the signup section is currently experiencing. Perhaps I should rephrase that. The Federal exchange website has allegedly been tested thoroughly from end to end by the government. Clearly, though those tests weren’t intense or accurate enough.

Widespread Malfunctions on the health exchange

Those concerns aside, why are widespread malfunctions still happening at this point? The open enrollment clock is ticking and many people who need health insurance plans next year might not be able to get it by January 1st if these errors keep up.

Last week many of the 14 state run health insurance exchanges experienced the same problems that the Federal government is still dealing with. But the states were able to scale up their systems pretty quickly and the majority of state exchanges were running smoothly by the end of week one. Hawaii is the glaring exception.

It might have something to do with the complexity of the system itself, which has to check your information simultaneously against IRS records, the Social Security Administration, and the Department of Homeland Security. Oh and don’t forget about Experian’s credit reporting services.

Issues with health insurance information

This is also all in addition to the system pulling in health insurance information from the servers of the health insurance companies and then returning to them your information to sign you up for insurance.

Most seem to be placing the blame squarely on the federal government for the problems so far. A piece in the Washington Post highlighted the contracting practices of the federal government. An expert quoted in the piece commented that when it comes to Information Technology services the government tends to select those companies that are good at navigating the bureaucratic process and not so much capable of creating an effective system.

The federal government has maintained its stance that everything was tested thoroughly and the glitches are just a result of massive traffic to the exchange page. There is some validity to that claim. However, they’re going to need to do a lot more to fix these problems than just add more servers. There appear to be other problems out there for people who have been able to buy health insurance. According to Bloomberg News, a lot of insurance companies are getting health insurance applications from the Federal exchange that have faulty information in them.

Right now it’s not such a big deal because only a few applications at a time are getting through. It could turn into a much bigger problem if it persists once the registration system is fixed and thousands of applications are coming in.

Either way, though it looks like even if the Federal exchange is fixed tomorrow, the public relations damage is done. According to a new poll, just seven percent of Americans think the rollout of the exchanges has gone well.

Here’s hoping for a better week three!