Confusion reigns over health care exchange

Administrators, advisors and agents suggest wait-and-see approach

by Kurtis Workman
Press Staff Writer

Just over a month into the Affordable Care Act problems and frustrations abound as state and federal agencies struggle to make it possible for Americans to access health insurance.

As of Tuesday, Oct. 1, every American is included in history’s largest open enrollment period. The Affordable Health Care mandate that every American have health insurance is now law. According to the law commonly referred to as Obamacare, every person must have an acceptable health policy with an effective date of Wednesday, Jan. 1, 2014, or face a penalty, tax or fine.

The easiest path for many is to go to the personnel manager at the company they work for to find out if the group policy that company offers meets the ten Essential Health Benefits. If the offered policy fulfills those requirements then just accept the policy as a benefit of employment.

The ten Essential Health Benefits include: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse disorder services including behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventative and wellness services including chronic disease management and pediatric services including oral and vision care.

The first step in the process is determining if a person or family qualify for one or both of the two subsidies offered. Through the federal program individuals or families can possibly qualify for a premium subsidy or a co-pay subsidy. One way to determine which subsidies the applicant qualifies for and how much is to access

The first thing that becomes apparent when accessing is there is not much there. The second thing most people will notice is how confusing the site is.  Most of the links move the user from the Idaho site to another website, usually the federal government website,, or the websites for individual companies offering insurance through the Idaho exchange. According to Idaho Exchange Operations Project Manager Alberto Gonzalez the website is not at the level that is expected.

“This is not ideal, but we are working toward that ideal. If we had the functionality we wanted to have on Tuesday, Oct. 1, this would be a smooth customer experience,” said Gonzalez.

Gonzalez acknowledges the failing of the website.

“We understand there are issues and confusion. This is not the experience we want consumers to have,” Gonzalez said.

The primary reason for the confusion, according to Gonzalez, is a lack of time.

“We began work on creating the exchange, essentially, on July 1. Most of the states that have state-based exchanges have been working on this for almost two years,” said Gonzalez.

To fill in the gap between meeting the federally mandated start date of Tuesday, Oct. 1, and the final vision for the Idaho exchange, project managers and designers have used the federal government website. Gonzalez said the choice to use the federal website was a matter of priorities.

“Because our staff started on July 1 and we only had until Oct. 1 to get ready there were a list of things we needed to accomplish in a short amount of time. We had to establish call centers, collect a list of In-person Advisors as well as Agents and Brokers and conduct training with all of these people. There simply wasn’t enough time to do all of those things and create a full, self-contained website,” said Gonzalez.

Gonzalez said even with the short time frame for development of the state website the list of problems with the federal website has complicated the development process.

“The problems with the federal system have rolled down hill,” Gonzalez said.

District 28 Representative Kelly Packer said the decision to use the federal website to augment the Idaho exchange is a double edged sword.

“It was a good choice to use the federal website as the back end portal because we did not default on the Oct. 1 deadline. Do we have the usability we wanted? No. Some of the things going on now are out of our hands because it is the federal government’s website. At the state level we are continuing to work towards a better system,” said Packer.

One of the primary purposes of having an online exchange, according to the advertising on is to be able to compare rates and coverage plans offered by different companies easily. There is no form or page that puts that information in one single place on the Idaho exchange website. Gonzalez said for the developers, having a comparison tool is important, but at this point the development of that tool is up to the federal government.

“That is one of the most important things this website needs to have. When it becomes a totally Idaho run website we will have that tool in place. Right now because we are using the federal website it is up to them to create that tool. The federal government has the form and we have requested one for Idaho. Right now it is a matter of them inputing the information and posting it to their website. We expect that tool to roll out in the next few days,” Gonzalez said.

A more user friendly shopping guide was added to the website on Thursday, Oct. 31. The interactive PDF file is ac

Leave a Reply

Your email address will not be published. Required fields are marked *