buyers expectations

Healthcare Reform

Calibrating Consumer Expectations for ACA’s October 1 Debut

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buyers expectations

All will not be perfect for enrollment on October 1, but do buyers know that yet?

Peter Lee, executive director of the Covered California insurance exchange, predicts only two people will actually buy insurance on the exchange on October 1.

At least, that’s what he told a room full of reporters last week.

He was being facetious of course, but his comment gets at the heart of an issue that’s been on the minds of healthcare professionals for months: Just how important is that opening day?

“When people ask the naïve question about ‘is it going to go live on 10/1,’ it’s not a binary answer,” said Kevin Walsh, who leads Eligibility And Insurance Exchange Services for Xerox’s Government Healthcare Solutions. “It’s not yes or no, it’s a long story.”

Shortfalls and delays in some states have been noted already. Washington and Oregon have already announced that their statewide exchanges will be delayed, and California itself announced a probable enrollment delay for some applicants.

Just last week, the White House delayed enrollment for small businesses and Spanish speakers.

“The general message is, this is a new industry, for all intents and purposes,” Walsh said. “We are covering a whole population of people we’ve never covered before.”

Industry speed bumps have been myriad, with each state trying to keep many balls in the air: From building exchanges and securing data centers, to testing Medicaid and CHIP eligibility systems, to communicating with the federal data hub, staffing call centers and more. Often, at least one of those elements fell behind schedule or faced unforeseen challenges.

“From a state perspective, we need to expect that they’re going to encounter the unexpected,” Walsh said.

With all that anxiety and heated conversation bearing down on that first day of October, consumers may still line up to buy.

For some people, buying insurance on the exchanges might be the biggest purchase they’ve ever made, but customers should keep in mind that being first in line doesn’t necessarily afford any benefit, he said.

“Citizens need to be patient for the first couple of weeks, and they need to realize they’ve got three months to do this,” he pointed out. “So if it doesn’t work on day one, don’t kill yourself trying to stay on the computer for 24 hours, just come back in a few days and check again.

“The way I look at it: You’re probably going to be able to get through on the phone and talk to someone, but who knows if you’re going to get in right away or have to wait 10 minutes? Why be part of the frustration group when you can wait a week until we add more people or add more phones?”

That doesn’t mean people should abandon the exchanges entirely, that just means be patient, but be persistent. In fact, if too many people face frustration at the beginning and give up, then too few may actually enroll in the exchanges, which rely on large numbers of enrollees to function.

“It’s kind of like opening a new supermarket: You can have really pretty aisles and displays, but if nobody shops, you won’t be able to stay open long,” Walsh said. “That’s the next wave people are starting to get anxious about, because it is a whole new enterprise.”