WEDNESDAY, Oct. 9 (HealthDay News) -- Unlike the highly
publicized problems that have plagued the federal health exchange
website created to help Americans register for insurance coverage,
many state-run exchanges are operating well, according to published
The reason for the disparity: the sprawling federal website has
been overwhelmed by visitors and -- some experts contend --
hampered by faulty design and software. The state-run sites, by
comparison, are much smaller and nimbler, and technicians can react
quickly to fix problems that arise,
The New York Timesreported Wednesday.
"Individual state operations are more adaptable," Alan Weil, executive director of the National Academy for State Health Policy, an independent nonpartisan group, told the newspaper. "That does not mean that states get everything right. But they can respond more quickly to solve problems as they arise."
Another difference that helps to explain the relatively smooth
launch of the state-run exchanges: some states let consumers
explore insurance options -- such as costs and the pros and cons of
different policies -- without first having to create an online
account. On the federal exchange, called HealthCare.gov, shoppers
must first create an online account. And creating an online account
has been a major stumbling block and source of frustration for many
people trying to use the federal exchange, the
Minnesota's health exchange is an example of a state-run
exchange that is performing well, the newspaper said.
Robyn Skrebes of Minneapolis, who is 32 and had lacked
insurance, said she signed up for health coverage in about two
hours on Monday using the state-run website, MNsure. She said she
purchased a policy for $179 a month, before tax credit subsidies,
and also got Medicaid coverage for her 2-year-old daughter, the
"I am thrilled," Skrebes said. "It's affordable, good coverage. And the website of the Minnesota exchange was pretty simple to use, pretty straightforward. The language was really clear."
Other states with state-run exchanges that seem to be operating
well since their Oct. 1 introduction include California,
Connecticut, Kentucky, New York, Rhode Island and Washington, the
Meanwhile, problems continue to dog the federal health exchange
website, which serves people in 36 states, according to published
Washington Postreported Wednesday that big insurance
companies, state health officials and Democrats friendly to the
Obama administration said they'd been warning federal health
officials for some time that the federal exchange had serious
shortcomings. The White House proceeded with the Oct. 1 launch
despite those warnings, the newspaper said.
Rep. Robert Andrews, D-N.J., played a major role in helping to
get the health-reform law known as the Affordable Care Act passed
in 2010. The online exchanges -- the federal site and the state-run
ones -- are key components of the law, sometimes called Obamacare,
which is designed to bring health insurance coverage of millions of
Andrews told the
Postthat he told White House officials early this summer
that he'd been hearing from insurers that the federal online system
"Nothing I told them ever surprised them," Andrews told the newspaper. "The White House has acknowledged all along something this massive was going to have implementation problems."
One senior administration official, who requested anonymity from
Post, said the Obama administration expected some problems
with the launch of the federal health exchange, "but we had a lot
more traffic than we thought, and so discovered problems managing
Daniel Mendelson, chief executive of Avalere Health, a research
and consulting company, told the
Times: "On balance, the state exchanges are doing better
than the federal exchange. The federal exchange has, for all
practical purposes, been impenetrable. Systems problems are
preventing any sort of meaningful engagement."
On Sunday, federal officials, who originally blamed high traffic
for most of the federal exchange's problems, acknowledged that many
of the difficulties consumers were encountering were due to design
and software problems,
The Wall Street Journalreported.
"We can do better and we are working around the clock to do so," said Joanne Peters, a spokeswoman for the U.S. Department of Health and Human Services.
HealthCare.gov stumbled out of the gate Oct. 1 -- the first day
of open enrollment under the Affordable Care Act -- as consumers
tried to peruse their health-plan options and enroll in
In the hours and days after its launch, consumers encountered
long lag times and technical difficulties.
U.S. health officials have said they see the heavy traffic on
HealthCare.gov as an indication of the demand for health insurance.
The administration hopes to enroll 7 million uninsured people
through the federal and state health exchanges by the end of March
Here's how to find
the health exchange serving your state.
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