With fewer than 100 days until the exchanges launch, are we ready?

State, federal officials scramble to meet Oct. 1 deadline

Topics: Access to Care, Quality, Performance Improvement, Appropriateness, Health Policy, Market Trends, Strategy

June 28, 2013

Officials are scrambling to prepare for the launch of the Affordable Care Act's (ACA) health insurance exchanges on Oct. 1, a deadline that now is just 95 days away, Kaiser Health News reports.

"The next 100 days are the sprint to be the biggest open-enrollment season we've seen in this country," said Ceci Connolly, the managing director of PricewaterhouseCoopers' Health Research Institute. "We know that this will be a real crunch period," she added. On Monday, HHS Secretary Kathleen Sebelius said that she hopes to see seven million residents enrolled in the exchanges by the end of March.

President Obama and federal health officials say the exchanges will be ready in time for the Oct. 1 launch date. However, a Government Accountability Office (GAO) report released earlier this month suggests that may not be the case.

According to KHN, state and federal officials face several challenges in their implementation efforts, such as:

  • States' reluctance to participate.
  • Critics' predictions of unaffordable coverage: It remains unclear whether young, healthy U.S. residents will be able to afford coverage in the exchanges, and their participating is key to keeping the beneficiaries pool balances since insurers cannot reject residents with pre-existing conditions.
  • Unexpectedly tight funding for consumer outreach: The ACA includes funding for outreach in states that create their own exchanges, but has little funding for outreach in the 25 states with federally run exchanges.
  • Technical challenges: Building back-end systems requires a complex infrastructure that connects state and federal agencies, as well as private insurers.

Beginning consumer outreach

The Obama administration's outreach effort is set to launch in mid-September, but groups like Enroll America—a group of organizations supporting the implementation of the ACA—used last Sunday's 100-day milestone as a "D-day" to launch exchange campaigns.

KHN notes that individual insurers are helping with the outreach effort because they stand to gain through the exchanges, especially in states with high projected enrollment. For example, Florida Blue is launching an education and marketing effort to reach more potential consumers.

"This is a huge communication and education undertaking for us," Jon Urbanek—one of Florida Blue's senior vice presidents—told KHN. He noted that many of the Florida resident eligible for subsidized coverage "don't even know what health insurance is" (Galewitz/Hancock, Kaiser Health News, 6/23).

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