After diluting the original requirements and purposes of the exchanges, they did open last week, well sort of. Many experienced serious problems, perhaps because of greater than expected interest, but more likely due to poor software and hardware, which really should not be unexpected in a large complex HIT undertaking. Consumers at most exchanges apparently had difficulty getting online, getting accurate information and particularly, getting enrolled. Concerns about privacy and security issues also were prevalent. While the Administration has misleadingly tried to present premiums on the exchanges as low, many consumers apparently were surprised by how much they would be paying for coverage. It is early, so we want to cut some slack on performance of the exchanges, but the Administration has showed extreme hubris from the start on the reform law, so there is little reason to be sympathetic to its problems with the exchange rollout. They should have been more upfront about the difficulty of implementing anything this complex. And of course, the real issues will come later, when subsidies are costing more than projected; there is widespread failure to obtain insurance among young people, and underpriced plans from relatively inexperienced players cause financial difficulties and coverage uncertainty. This law never should have been passed and more and more people will realize that as time goes on. UPDATE: We knew we were too generous; always a mistake and against our nature. The Wall Street Journal reports this morning that the federal website, responsible for 36 state exchanges, has serious design and coding flaws which basically make it non-functional. (WSJ Article) These idiots gave themselves over five years to get ready and still couldn’t do it. Meanwhile a number of private exchanges are up and functioning fine. Hooray for big government!!
