By Dena Bunis and Rebecca Adams, CQ HealthBeat
September 26, 2013 -- With the opening of the health exchanges still five days away, there's been a steady trickle of glitches in the system, the latest one that the Spanish-language version of the enrollment website for the federal exchanges is being delayed, as is the ability of some small businesses to go online to enroll in their exchanges.
President Barack Obama himself forecast such problems during a recent pep rally-style speech on the health care law in Largo, Md.
The inability of Latinos to begin signing up could be pivotal, given that Hispanics are a key target group for the health care law (PL 111-148, PL 111-152), with an estimated 10 million Latinos not having health coverage.
When it comes to the business sign-up, Health and Human Services (HHS) officials recently issued a news release highlighting the SHOP exchanges. Toward the end of the release they explained the delay.
"Unlike individuals purchasing through the Marketplace, small employers can enroll in insurance plans through the SHOP on a monthly basis throughout the year," the release said. "As such, some states are phasing in SHOP application and enrollment periods. The SHOP Marketplace for Federally-facilitated Marketplace states opens Oct. 1, 2013, when small employers can start the application process and get an overview of available plans and premiums in their area. All functions for SHOP will be available in November and if employers and employees enroll by Dec. 15, 2013, coverage will begin Jan. 1, 2014."
Insurance industry experts have been predicting such problems, pointing to the enormity of the task of standing up these new marketplaces, particularly in getting the systems to interface with the federal data hub that will hold the information exchange officials need to determine eligibility for the federal subsidies and Medicaid.
"I'm expecting more announcements," Robert Laszewski, an industry consultant, told HealthBeat. "I don't mean to be the guy with the dark cloud but there will be many more. I continue to hear from my health insurance clients who are working on this that there are loads of testing problems, lots of bugs" on the federal and state exchanges.
The problems, he said, range from getting the health insurance plans rates correct to concerns that the federal exchange may not be able to transmit who will be in which plan until November. "So people will sign up but insurance companies won't know for weeks," Laszewski said, suggesting that exchanges managers may be waiting to reveal some of the problems "because they so much don't want to put out bad news."
Apparently not all of the business exchanges will be affected by a delay.
"Our SHOP exchange will be fully functional on October 1,'' said Richard Sorian, spokesman for the D.C. marketplace. "Employers will be able to do everything including. Plus we have a secure portal for brokers that will be up soon too."
Some sources said that the technical problems are widespread, with at least a few states said to be waiting to send enrollment information to insurance companies until early November because of systems errors.
A Centers for Medicare and Medicaid Services official declined to comment.
GOP lawmakers and a small business group said the SHOP exchange delay points to bigger problems.
In his speech, Obama predicted that health law naysayers would seize on any glitch in their effort to denounce the law.
"There are going to be some glitches as this thing unfolds," Obama said. "Somewhere around the country, there's going to be a computer glitch and the website's not working quite the way it's supposed to or something happens where there's some error made somewhere.
That will happen. That happens whenever you roll out a new program. And I guarantee you, the opponents of the law, they'll have their cameras ready to document anything that doesn't go completely right, and they'll send it to the news folks, and they'll say, "Look at this, this thing's not working."
"At the exact same time the President was again promising Americans that the health care exchanges were ready to launch, his Administration was announcing another delay," Sen. John Barrasso, R-Wyo., said in an emailed statement. "This is just the latest example of his rhetoric about the law not matching reality. It's clear that the exchanges aren't ready for prime time—and the law isn't working to deliver affordable, high quality care. We need to repeal it and replace it."
At the National Federation of Independent Business, Kevin Kuhlman, head of legislative affairs, said in a statement that, "Every step in the implementation process has seen delays and setbacks; we are certainly not surprised by this one. But with this latest glitch in the small-business exchanges, the case for a delay of the individual mandate alongside the employer mandate only grows stronger. Small-business owners should not be forced to comply with a law that is clearly not ready for prime-time. This is starting to seem like a parody; unfortunately, it is extremely serious."
And Sen. Orrin G. Hatch, R-Utah, said in a statement that, "This law is a disaster, but the exchanges—the heart of the law—are supposed to go live in just five days? Give me a break. This law will never be ready for primetime, because this is what happens when Washington takes over health care. It's time for a permanent delay of this disaster for families, for businesses, for students and for seniors—and I commend House Republicans for including it in their debt ceiling package."