Crunch time looms for insurance exchange

Here’s how it works:

Alternatively, you can call a customer service representative for help at 1-800-318-2596. Hearing impaired customers using TTY/TDD technology can dial 1-855-889-4325.

Who will be selling on the exchange:

Seven insurance companies have filed proposals to offer health plans on the Georgia exchange. They include:

Some regions of Georgia will have more insurance options than others, since most insurers will offer coverage in select areas. Only Blue Cross will offer plans statewide.

In 90 days, thousands of Georgians are expected to begin shopping for health coverage on a new online insurance marketplace created under the Affordable Care Act. That is, if it’s up and running on time.

Federal officials face tight deadlines to launch the insurance websites, called exchanges, in the 34 states that opted not to build their own. It’s a formidable task that has some industry observers questioning whether the sites will really be ready for shoppers by Oct. 1.

IT systems that will provide access to federal and state eligibility data, such as income and citizenship status, must still undergo final testing. Regulators must approve scores of health plans insurers want to offer on the exchanges. A new workforce of so-called “health insurance navigators” who will help consumers has yet to be hired.

The workload is especially onerous in the Southeast, where seven of eight states, including Georgia, have ceded responsibility for the exchanges to the federal government. Only Kentucky is building its own.

“(Other regions) don’t have nearly the amount of work we have to do,” said Renard Murray, administrator of the Atlanta and Dallas regions for the Centers for Medicare & Medicaid Services, or CMS. Still, he said: “the Georgia system will be ready.”

The insurance websites are a critical part of the health care law. The goal: Provide millions of Americans who don’t get insurance through their jobs — the unemployed, self-employed, students and others — with access to affordably-priced coverage from a participating private insurer.

This week’s announcement by the Obama administration that another part of the law requiring certain smaller businesses to offer insurance or face penalties will be delayed a year doesn’t effect the exchange deadline. In fact it makes the exchanges more important, as they could give currently uninsured workers a way to find insurance while waiting for the employer mandate to kick in.

The exchange websites will enable consumers to compare prices and get federal subsidies for coverage if they’re eligible. Officials expect about 7 million Americans to enroll in the exchanges by next year.

The Obama administration had originally hoped more states would build their own exchanges. But many state leaders, including Gov. Nathan Deal — an avowed foe of the ACA — chose to let the federal government do it instead. Deal said last fall that Obamacare’s one-size-fits-all approach had too many regulations that prevented Georgia from creating an exchange to meet the unique needs of its residents.

Sixteen states and the District of Columbia are creating exchange websites themselves. The federal government must do much of the rest.

“Much progress has been made, but much remains to be accomplished within a relatively short amount of time,” according to a recent report by the U.S. Government Accountability Office. Critical tasks remain to be done and missed deadlines closer to Oct. 1 could hinder roll out of the exchanges, the report shows.

President Barack Obama also predicted in a recent speech that there will be some “glitches” and “hiccups” as the exchanges get underway.

Officials with the Department of Health and Human Services say, however, they are working to make sure consumers have access to affordable health coverage as promised.

Last week, the administration unveiled a revamped HealthCare.gov where shoppers can begin exploring options. Call centers are also already up-and-running to answer questions.

“We have already met key milestones and are on track to open the marketplace on time,” a department spokesman said.

This isn’t the first time federal health officials have undergone such a massive effort.

In 2006, the government rolled out Medicare Part D, a prescription drug benefit, to millions of people. The process was anything but smooth in the beginning and, experts say, offers some lessons for the exchange roll out.

For one, caseworkers will be provided to consumers who need extra help, said Murray, the Atlanta CMS chief.

Outreach to let people know the exchanges exist will still be a challenge even when the sites are up and running, said Tim Sweeney, a health policy analyst with the nonprofit Georgia Budget & Policy Institute.

States building their own exchanges, such as California, have put more effort into consumer education, Sweeney said.

“Georgians may be at a disadvantage if there’s less education and outreach going on here,” he said.

Murray told The Atlanta Journal-Constitution his team is visiting or contacting hospitals, community groups, nonprofits and other organizations to get the word out. Staff members recently went to an Atlanta LA Fitness to hand out information and plan to hold events at local libraries.

They’re spreading the message via radio, television and other media. Information can be found on Twitter, Facebook, YouTube and other online forums. Call centers are open 7 days a week with help available in 150 languages.

Murray added that final approval for qualified health plans insurance companies propose to offer on the Georgia exchange is expected soon.

“We’re on target and ready to get moving,” he said.

Still, more hurdles could emerge in the coming weeks if states that are launching their own exchanges, such as Hawaii or Idaho, aren’t ready in time, said Jennifer Tolbert, head of state health reform for the nonprofit Kaiser Family Foundation. The feds would be forced to step in and help out with those too, Tolbert said.

The federal government has obviously made a lot of progress, but “we have no way of knowing if they’ll be ready,” Tolbert said. “It’s safe to expect that there will be problems and glitches.”