If you're looking at a list of the milestones for implementation of health care reform, you'll see that we've just reached a big one: the opening of the public insurance exchanges.
Ok, so the day is largely symbolic. Nothing really takes effect today. It just happens to be the first day we can go take a look at what's available through these new marketplaces and begin the process of enrolling for coverage if we want. Coverage purchased through the exchanges between now and December 15 won't be effective until January 1, 2014. But it still feels like there has been a lot of anticipation in the run-up to the opening of the exchanges.
I happened to be awake after midnight last night, so I decided to try out the portal for the Kansas exchange. We don't have a state-based exchange (the federal government is running one for us), so I went to the federal exchange website (www.healthcare.gov) and starting working my way through the process.
I didn't get very far. One of the first things you have to do is set up an account. This requires selecting a user name and password and also answering a series of three security questions, so you can retrieve your user name and password later if you forget. The user name and password part worked fine. And the interface would allow me to answer the security questions, but it wouldn't tell me what the questions were.
It felt a little like that bit Johnny Carson used to do where he'd hold an envelope up to his temple, conjure up the answer to a question, and then open the envelope to find out the question. Except not as funny. And I wasn't wearing a goofy hat or turban or whatever he would put on.
Anyway, I gave it my best shot: (1) green, (2) Roosevelt, (3) peanut butter. The exchange didn't like my answers. It told me the system was unavailable and to try again later. I haven't been back yet.
The news reports today indicated that many of the millions of other Americans that tried logging in faced similar problems. Does this mean the exchanges are doomed? Probably not. They'll get the glitches worked out in plenty of time for people to get enrolled in coverage by January 1, if they want it.
But I do wonder about the broader impact of even a temporary delay in the enrollment process. I was looking at the exchange as a mostly academic exercise. I'll likely be getting my health insurance next year through my workplace. And even if I did need to buy my coverage through the exchange, I'd likely find my way back before January 1. I've got a spouse and two young children, so health insurance isn't really optional for our house. But what if I was one of those young invincibles - the twenty-somethings that we need to bring into the system to help balance out the cost and risk structure? The exchange might have gotten my attention once, but that may have been it.
I guess time will tell.
And, of course, this is just one of many markers on the road to health care reform. Even with the play-or-pay delay, there's lots to think about between now and the end of the year and likely much more guidance to digest - at least once this whole shutdown thing gets resolved. So don't get too relaxed yet.