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Obamacare’s major data challenge

By Jay MacDonald · Bankrate.com
Tuesday, July 23, 2013
Posted: 6 am ET

Why did the Obama administration recently grant the new state health insurance marketplaces a 12-month extension, until 2015, to meet the health care reform requirement that they routinely verify the income and employer insurance status of online applicants?

Short answer: The top priority now is, above all else, to make sure the new online marketplaces run smoothly when they make their public debut Oct. 1.

While politicians continue to clash over the merits of the Affordable Care Act, technology professionals are hammering back the Red Bull to make sure millions of Americans come away with a positive experience the first time they log on to their state's health insurance site.

The exchanges have to work

The holy grail is to deliver a "no wrong door" interface, so users never meet a dead end or have to re-enter data they've already provided.

What makes that such a daunting task is that each state's online computer portal must interface with legacy (read: old) federal computer systems that have never been asked to provide real-time verification of things such as whether Jane Doe's income qualifies her for a federal health care subsidy. Obviously, "We'll get back to you" is no longer an option online.

"Nothing like this in IT has ever been done to this complexity or scale, and with a timeline that put it behind schedule almost before the ink was dry," Rick Howard, research director at the technology advisory firm Gartner, told Reuters.

In fact, the challenge is so great and the timeline so compressed that Idaho and New Mexico, which had intended to set up their own marketplaces, opted instead to let the feds do the heavy lifting.

The clock is ticking

Several worst-case scenarios keep marketplace IT professionals up at night. In one, every resident of a state might log on all at once come Oct. 1 and immediately crash the system. In another, the federal hub might become so bogged down that consumers either log off in frustration or resort en masse to the state's call center, overwhelming it.

There's cause to worry: Snafus aplenty occurred when Medicare unveiled its prescription drug plan in 2006, resulting in seniors being enrolled in several plans or having the wrong premiums deducted from their Social Security checks.

That's why the states and the feds are putting their systems through extensive systems checks this summer to prepare for something that's never been attempted on this scale.

As President Barack Obama acknowledged, there are bound to be "glitches and bumps" when these first-ever marketplaces go live in three months.

But my guess is, the prospect of millions of Americans finally being able to afford health insurance will far outweigh any temporary online inconvenience.

Follow me on Twitter: @omnisaurus.

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Jay MacDonald is a Bankrate contributing editor and co-author of "Future Millionaires' Guidebook," an e-book by Bankrate editors and reporters.

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