Since healthcare.gov launched on October 1, we've covered the ups and many, many downs of the glitchy, arguably poorly-designed federal Obamacare exchanges. Meanwhile, some states running their own exchanges have been doing pretty well. The New York Times interviews a woman in Minnesota who was able to sign-up for health insurance in about two hours.
On Tuesday, The Washington Post's Sarah Kliff attributed at least part of the site's turnaround to how easy it is to use. For instance, one complaint about the federal exchange site has been that users have to register for an account before they can browse insurance plans. In Minnesota, Kentucky and Connecticut, you can browse first, create an account later. Kliff argues that the browse first option is probably sparing the site from the "bottleneck" of people trying to create accounts. "This isn't what Obamacare looks like in the federal marketplace, where it's still difficult to even create an account or browse options. It is what it looks like when Obamacare works," she said.
Put another way, the state-run sites are flexible and nimble in a way the federal exchange isn't. "Individual state operations are more adaptable. That does not mean that states get everything right. But they can respond more quickly to solve problems as they arise," Alan R. Weil, the executive director of the National Academy for State Health Policy, told the Times.
Currently 16 states and the District of Columbia have their own exchanges (though Idaho and New Mexico are temporarily using federal infrastructure). The federal government is keeping mum on its numbers, but states have slowly begun to release their enrollment numbers in the last few days.
- California has 16,311 completed and verified applications
- In New York, 40,000 applications for insurance were approved
- Washington has 9,542 individuals fully enrolled
- In Kentucky, 7,000 people have enrolled in a healthcare plan
- Connecticut's exchange has processed 1,175 applications
But Weil's also right to point out that states are dropping the ball, too. Minnesota's state-run exchange, MNsure, was only able to processes applications for Native Americans this week, after fixing problems with processing specific subsidy eligibility. Minnesota, along with Rhode Island and Nevada, has also had trouble verifying the identities of those attempting to sign up, though that glitch is a result of connecting to a federal database. And as of Monday, Cover Oregon was unable to enroll individuals in insurance plans.
Still, it's the federal exchange that's causing the most head shaking and hand wringing. We're hardly halfway through week two of the the six month enrollment period, but with each day there's some new error (or explanation of errors) to examine.
As Politico noted today, some people are concerned that users who create accounts on the federal exchange aren't able to delete the accounts afterwards. On the one hand, since you have to create an account to shop for plans on the federal site, this is annoying. "You don’t want that information persisting on the website, especially when it’s clear you’re no longer interested in creating the account," a policy analyst told Politico. Then again, another consultant said it didn't seem like a big deal. "It doesn’t sound sinister to me," he said. "It sounds bureaucratic and that no one’s thought about that yet."