Uh-oh, the Exchanges May Not Be Ready On Time

Government health information technology efforts have a long history of failing, wasting hundreds of millions of dollars and delivering useless functionality.   So there should be no surprise that the Government Accountability Office finds in a new report that the insurance exchanges mandated by the health reform law are behind schedule.   (GAO Report)   States could either do the exchanges totally themselves, work with HHS to create one, or leave the responsibility totally with the federal government.  Unfortunately for HHS, 19 states had the foresight to leave the mess completely to the feds and another 15 states and relying on HHS in part.  All the exchanges are expected to be up and running by October 1 of this year, to enable enrollment for the 2014 year.  HHS only recently finalized much of the necessary rules and guidance for exchange functioning.  A critical piece is a data hub and establishing and operating major databases is a complex task, one that the federal government has a wonderful record on, especially in the health world.  This particular data hub needs to draw from several other well-functioning (not) federal databases.  It seems very unlikely that adequate testing will be completed prior to October 1.  The process of setting up the “navigators” who are supposed to help consumers understand and make choices in this new, simple, health care world (why are they needed if it is so simple?) is at least two months behind schedule.  And of course all of this is costing far more money than originally projected, much of which will be paid by individuals in the form of greater assessments and taxes on insurers.  Our money is on the federal exchanges not being fully functional on time and on people being extremely frustrated by very slow response times from the federal data hub and other critical aspects of the exchanges.  There is a reason why the biggest private insurers are taking a very cautious approach to selling on the exchanges.