What Will Really Happen October 1st For Health Reform?

10/1/13…That is the date that the healthcare exchanges will go-live (or at least are supposed to go live).  As of a week ago, the testing hadn’t even begun.  Will they actually get through all the testing and go-live in time?  It will be a huge failure if they don’t.

On the flipside, if they go live but the experience is horrible and pricing is wrong, will that reflect poorly on the exchanges or on the health insurance companies?  I know several of the large health insurance companies who are ready (or as ready as they can be) are worried about that.  

There are other issues to be sure:

  1. Do people even know that the exchanges exist?  (A recent survey said only 27% of young people did.)
  2. If people know, will they come to buy insurance?  Will they understand the exchanges and that they can get a subsidy?
  3. Will exchanges end up with only the sick or will there be a mix of healthy and sick?  (This will eventually be an issue, but plans will have to underwrite for 2015 exchange pricing before they really understand this.)

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