State health exchanges outpace HealthCare.gov
- By Kevin McCaney
- Oct 25, 2013
As people continue to struggle with the federally run HealthCare.gov website and the Health and Human Services Department works on solving its enrollment problems, residents in 14 states and the District of Columbia are having a different experience with their state-run health care exchanges.
In some cases, not necessarily better, just different. But in others, people are finding that signing up for health insurance has been relatively easy.
Kentucky, Connecticut and New York, for example, are among the states that have had fairly smooth rollouts, even if they struggled with high traffic on the first day or so. Sites in Vermont, Maryland and Oregon have had more problems. Hawaii, by most accounts, has had the roughest go of it among states running their own exchanges; technical problems left the state’s site unable to display insurance plans and prices until Oct. 15, more than two weeks after the Oct. 1 launch.
Overall, however, most of the state exchanges are working better than HealthCare.gov. The sites are intended to let people sign up for health insurance under the Affordable Care Act, which gave states three choices: set up their own exchanges, rely on the federal site or develop a combined state/federal “partnership” site.
When ACA was passed, the administration assumed that most states would be running their own exchanges, which didn’t pan out. That led to HealthCare.gov taking on a bigger portion of the work than anticipated, which may have contributed to its problems.
One thing some of the state exchanges may have going for them is their smaller size and, in some cases, simpler designs. Kentucky’s site, Kynect, went with a more spare design than HealthCare.gov and some other state sites. Officials have said that coordination among agencies involved helped the effort.
Also, unlike HealthCare.gov, Kynect underwent extensive testing before its launch, the Wall Street Journal reported. NIH didn’t test HealthCare.gov until several days before the launch, and then found the system crashed when a few hundred users tried to log in at once.
Like most sites, Kynect was stymied by heavy traffic early on Oct. 1, but added servers and processing power, and was fully functional by 3 p.m. that day, the Journal reported. The state said that nearly 270,000 people had conducted preliminary screenings, over 51,000 applications had been started and more than 26,000 people have been enrolled.
New York’s exchange, NY State of Health, likewise had a rocky start during the first week, when it reportedly recorded 30 million hits. But officials increased server capacity and made other improvements. Elisabeth Benjamin of the Community Service Society of New York, which works with community groups that serve as navigators to help people sign up, told Gannett’s lohud.com that the site has been steadily improving.
As of Oct. 24, nearly 174,000 people had signed up via NY State of Health, and more than 37,000 were fully enrolled.
One aspect of HealthCare.gov that has worked well — and which the states rely on — is its data services hub, which links records from federal agencies with the state exchanges to verify applicants’ identities. Chris Clark, technology program manager for Kentucky's exchange, told the National Journal that 92 percent of Kentucky’s applicants had been verified successfully.
Kevin McCaney is a former editor of Defense Systems and GCN.