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Not a Third World Experience

Not a Third World Experience

Neil Minkoff, MD

The title is part of a quotation from Henry Chao, a CMS official who is involved with building and launching the health care exchanges. The federal government is running or co-managing 33 exchanges. They are expected to be functional by October 1 to enroll patients for coverage starting on January 1.

At a recent panel discussion at Americas Health Insurance Plans (AHIP). more than one government official showed some apprehension about missing the deadline. Chao’s full statement was, “The time for debating about the size of text on the screen or the color or is it a world-class user experience, that’s what we used to talk about two years ago. Let’s just make sure it’s not a third world experience.”

This will be a huge blow to consumers who will be depending on exchanges for next year’s coverage.  Further, a lot of those consumers don’t even realize that an exchange is in their future, so they’re not paying attention yet. The rest of our industry should be spurred to action as well. We are depending on those exchanges as a key part of our engagement and sales.

Another official, Gary Cohen of the Center for Consumer Information and Insurance Oversight, said, “There is contingency planning that is going on...” to address the issues expected to arise.

Further complicating the matter is that the 18 states building their own exchanges have earned only conditional certification. This means that the federal government could need to step in to support any of the 18 that aren’t ready. (Yes, that does make 51 — Washington, D.C. has its own exchange.)

It is unclear what issues consumers will face on October 1, and the administration’s officials don’t seem to be getting more specific. Chao said that contingency plans include everything from website operations to call centers.

One thing is clear: Health plans that expect to offer products through exchanges need to be prepared as well. Redirecting patients to your own web sites and consumer help lines may prevent catastrophe if your state’s exchange fails. The feds are preparing for failure; if you plan on using the exchange, you need to plan for that failure, too.

Neil Minkoff, MD, is medical director of MediMedia Managed Markets and also an independent health care consultant.