The Affordable Care Act is likely to have a rocky enrollment start on Oct. 1 in some U.S. states, because of ongoing technology challenges facing new online health insurance exchanges, a leading expert told U.S. lawmakers on Tuesday.
“At this moment, not a single state appears to be completely ready,” W. Brett Graham of the Salt Lake City-based consulting firm Leavitt Partners said in testimony to a Republican-controlled oversight panel in the House of Representatives.
He said states should be capable of providing “baseline functionality” when enrollment begins in three weeks. But he cautioned about the potential for delays.
“Most, if not all, exchanges will experience a rocky enrollment period as they work to overcome both known and unknown operational challenges.”
Leavitt Partners has been involved in the design and development of some state exchanges, also being called marketplaces by the Obama administration, and tracks exchange progress nationwide. The firm is headed by former Health and Human Services Secretary Michael Leavitt, a former Utah governor who held the health post under Republican President George W. Bush.
Graham's assessment for states that are working with the administration to implement the health care law was in sharp contrast with comments from technology contractors working to ready a federal marketplace for 34 states that have chosen not to set up their own exchanges.
Officials from technology contractors CGI and QSSI told the same House Energy and Commerce subcommittee hearing that they are on schedule for federal exchanges to begin operations as expected on Oct. 1.
Graham did not identify the states that are facing challenges. Oregon has said it will delay full public access to its exchange for several weeks in October. California's exchange said on Monday it would be ready for full enrollment in time.
The exchanges are key to the health care law's success as the vehicle for enrolling an estimated 7 million uninsured Americans in new health plans for 2014. They will have until March to sign up for coverage next year.
Graham said state capacity has been strained by trying to tackle the complexity of the information technology needed to run the exchanges.
Some states are having difficulty integrating exchange technology with existing Medicaid and other state systems, according to Graham, who said the results could include slow enrollment, delayed eligibility determinations and increased potential for fraud and abuse.
There has also been a lack of adequate state exchange testing with other platforms and the federal hub system that the Department of Health and Human Services has built to transfer consumer information between federal and state agencies, Graham said.
A U.S. watchdog agency warned in August that the federal IT system was months behind on security testing and said the HHS deadline for certifying system security had been set back to Sept. 30. QSSI executive vice president Michael Finkel told lawmakers on Tuesday that the data hub completed a security risk assessment on Aug. 30 and should be on track for certification.