Week Three of the federal health insurance exchange: The week the government shutdown ended

Credit: NPCA Photos via Flickr under Creative Commons

Well, that was a scary couple of minutes there with the whole government shutdown and the looming possibility of a quite destructive national debt default. But now that all that drama is over (for the moment at least), what does it mean for the Affordable Care Act and the federal health insurance exchange, now in its third week?

As you may recall, the Affordable Care Act has been having a tough time ever since its online health insurance marketplaces, also known as the exchanges, opened up for business on the first of the month. The exchanges in case you’re just joining us are the places where people can go to purchase health insurance plans that meet the new standards of the Affordable Care Act and are also eligible for subsidies from the federal government.

The biggest problems have been centered around the federal health insurance exchange. States had the option back when the ACA first became law to establish and run their own health insurance exchange instead of participating in the federal exchange. 36 states opted not to run their own exchanges and the 14 others did.

For those 36 states that decision has proved fateful because of all the problems happening now with the federal exchange. Since it went live back on October 1st the exchange site HealthCare.gov has been a glitch-filled nightmare for a lot of people. The main problem with the site has been, and still is, the section where you set up an account to purchase health insurance.

Avik Roy, a blogger with Forbes and not a huge supporter of the Affordable Care Act, wrote this week on his blog about why he believes HealthCare.gov is crashing. The problem, he says, is that it’s structured so you cannot easily view the prices of health insurance plans, which presumably a lot of people are trying to do. He argues that the administration is trying to hide the real cost of health insurance plans without subsidies from the public. I’m not sure whether I agree with him about that last part, but HealthCare.gov would certainly be better if you could just see the prices without creating an account.

The Washington Post reported this week on a blog post from an insurance company insider who expressed his concern about the quality of the connection between the exchange system and health insurance companies’ systems. According to the blogger, there’s been anecdotal evidence of applications being submitted with wrong information, or just corrupted altogether. The Post reporter, Erza Klein, mused that right now this is not a huge problem because most people going to HealthCare.gov cannot get through or are just window shopping. But once the glitches in the account creation system are resolved the connection problem, if it persists, could be disastrous.

Finally a great analysis from Reuters out yesterday found that in the months leading up to October 1st, officials were very wary of the technical challenges the exchange was facing while the budget for building the exchange ballooned from an original $93 million to nearly $300 million.

Next week we wrap up our coverage over here of the first four weeks of the Affordable Care Act’s Health insurance exchanges. So stay tuned for more analysis!