IT Issues Could Delay Creation of Health Insurance Exchanges


State consultants and insurance regulators are warning that computer issues might hinder the creation of health insurance exchanges, Kaiser Health News reports (Appleby, Kaiser Health News, 11/14).


Under the Affordable Care Act, states by January 2014 must create online health insurance exchanges to provide coverage options for individuals and small businesses.

Most insurance exchanges will rely on a solid IT foundation to connect with advanced eligibility systems for Medicaid and other state-administered health programs (iHealthBeat, 11/12).

Delays in Updating Electronic System

Most insurers participating in the exchanges will need to use an electronic system -- called the System for Electronic Rate and Form Filing, or SERFF -- to submit their insurance policies for state and federal review.

Last week, state regulators were told that an updated version of SERFF will not be ready for testing next month, as was planned.

The delay could stem in part from the fact that the Obama administration has yet to release certain regulations that are needed before the software can be updated.

Kim Holland -- a former Oklahoma insurance commissioner who now is executive director of state affairs for the Blue Cross and Blue Shield Association -- said that the regulations are expected to provide details about the types of benefits that must be included in policies sold in the exchanges.

Reaction From Stakeholders, Observers

Holland said that if the delays continue, "it could make it difficult to have a robust and competitive marketplace on the exchanges."

Dan Schuyler -- a director at Leavitt Partners, a consulting firm working with states to set up the exchanges -- said that further delays could mean that states are "not going to be ready" to launch their exchanges by the January 2014 deadline.

Response From the Obama Administration

The Obama administration maintains that planning efforts for the health insurance exchanges are moving forward on schedule.

Administration officials also said that the exchanges will open on time (Kaiser Health News, 11/14).

Barbara Duck
Well IT is the secondary delay, first one will be the contracts, Blue Cross already having doctors to opt out otherwise they are in there to cover the consumers who buy from the exchange and a reimbursement rate of 30% less..I'd contracts are the first mountain to climb here. Everyone should know by now that the short order code kitchen burned down a few years ago so yes IT infrastructure..takes time.

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