"There are potentially 14 million new people walking through the electronic front door in light of ACA," said Garland Kemper, health and human services program director at services provider Unisys. "There are [state-based computer] systems that in some cases are 25 years old. They're legacy apps that, to modify the rules to reflect the new federal ones, will be very difficult. It varies state to state.
"This is going to be a huge impact to state government," she added.
One of the most cited problems by those attempting to sign up for healthcare insurance online was an issue associated with creating a password, which protects the enrollee's identity. Several members of national news organizations stated that people states including Maryland, Virginia, Hawaii, Michigan and Florida had trouble logging into the HIX website in order to enroll.
One of the problems is that some public HIXes, such as Massachusetts' Health Connector, have been online for years,. Other states found themselves behind the curve and faced tough deadlines to enact their exchanges. Massachusettts' Health Connector uses a model where the state evaluates and selects insurers in a competitive bidding process, and then offers those insurers to the public.
However, 36 states opted out of creating their own HIXes and instead opted to allow residents to visit the federally-created HIX, which offers a central database of insurers from which they can choose based on their state and economic status.
About 85% of Americans are already covered by some form of insurance, ether privately or as part of their benefits from an employer. The other 15% of Americans who are self-employed or unemployed are the target of the HIX system.
The Healthcare.gov site also offers an around-the-clock chat line to assist enrollees with the process. Some users found that service down, as well. Additionally, a Medicaid calculator tool that allows enrollees to calculate their tax credits after enrolling also experienced issues with accuracy.
Tavenner said part of the problem with the calculator has been that it double-checks all the results, which can result in slowdowns, but "we're seeing more accuracy," she added.
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