Several online health care exchanges got the opening night jitters on Tuesday, but three – Maryland, Minnesota and Hawaii – had total outages. Those who tried to sign on to investigate and possibly join a plan through the Obamacare marketplace in Maryland just plain had to wait.
“I’ve been hearing some of the exchanges are working OK and some are having glitches, but it definitely seems like there was a good response,” says Julie Stich, director of research at the International Foundation of Employee Benefit Plans.
LeAnn Tobin, senior vice president and director of the employee benefits division at the Bethesda, Md.-based consulting firm RCM&D, says that, while annoying, the technical failure “says there’s a lot of interest,” not a lack of preparation. “Maryland has spent a lot of money trying to get people aware of this opportunity to enroll in coverage,” Tobin says; the state thinks it can halve its uninsured population of 800,000 in the next six years.
“As happened in many other states, there was a logjam. Many more people went online than they expected … and the system just basically stopped,” Tobin says. “There were many, many people looking for information on the plans, and I think that’s a good thing. As every employer knows, when you roll out anything that has an online opportunity, there can be a chance of just too many people hitting the system at the same time, and clearly that’s what happened. All around the country, people just couldn’t get through.”
Speaking of getting through, Tobin says it would be “pure conjecture” at this point to speculate as to whether the young and healthy will actually sign up – a crucial development if the Affordable Care Act is to survive. She speculates, however, that the penalty alone won’t be enough to drive them into a plan.
“They’ve made strides to communicate to everybody,” she says. “The state of Maryland had even the Ravens’ help to make communications on this. Whether young people will reach out – I just don’t know. If we look at the law in totality, the overall first-year penalty is not a lot of money.”
Employers would do well to take advantage of the public spending and communication efforts, as such a push may not come again, says Alan Cohen, co-founder and chief strategy officer of Liazon, which runs the Bright Choices private exchange. “The government is spending a lot of money on teaching people about exchanges,” Cohen says, “a lot more money than we can spend” and dovetailing on their efforts would be wise.
“So now all of a sudden, you can imagine us five years ago going to companies and trying to explain, ‘Yeah, let your employees shop in a store and they can have all these options,’” Cohen says. “Companies were looking at us and going, ‘I've never heard of that before.’ Now companies don't say that anymore. It's becoming part of what's the accepted way to do business.”
Of course, the vast majority of employers aren’t discontinuing their health care coverage; most of those now going to state and federal exchanges are presently uninsured, not hunting for a different deal.
IFEBP’s Stich says that, even if employers aren’t planning on shifting populations to exchanges, their due diligence doesn’t end with notification that Obamacare exists.
“We’re suggesting that the employers or plan sponsors do communication proactively about ACA – what it does and doesn’t do, talk to them concisely about the law, just give them a little background information and explain how this may be affected what plan design changes employees may be seeing in their own plans,” Stich says.
Tobin says, moreover, that now is the perfect educational opportunity for employers to begin investigating private exchanges “that may become more of an option going forward.” ACA’s ultimate goal is more and cheaper health insurance coverage, and one hopes that private and public exchanges can become two fronts of the same battle. But don’t jump to a private exchange just because they’re out there, Tobin says.
“There are some that exist now; they are still very obviously infancy-stage,” she says. “Several of our clients have begun asking us questions about private exchanges and whether it’s an option for them to offer coverage to their employees. We are certainly going to help them to consider that, but more than anything at this point, we are typically saying go slow on the decision.
“These things are just starting. … Give it a chance to roll out for a couple of years. Let’s let it play out, let’s see how this is working. But is it something that should be considered in the future? Absolutely. It gives an opportunity for employers to manage the cost of care differently. It provides an administrative platform that is streamlined. It allows employers to get out of the day-to-day business of running a health care plan.”
Cohen says that “as the public exchanges become reality, as opposed to potential reality,” companies should consider the general trend toward consumer-driven health and observe how the process works in ACA marketplaces.
“Even if they have private exchanges, they need to think about this idea,” Cohen says. “Do they believe in this idea that people should make decisions instead of companies, that a person is better able to figure out what their needs are and the needs of their family are than a company is to figure out the average needs?”
EBN Managing Editor Andrea Davis contributed to this story.
