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HIX Are a Marathon, Not a Sprint

Margaret Dick Tocknell, for HealthLeaders Media, October 2, 2013

The impact of health insurance exchanges will take months and years to assess. December 15, not October 1, is the big date; young invincibles aren't essential yet; and it will be 2015 before the viability of HIX is known.

Open enrollment for the health insurance exchanges is a marathon, not a sprint, and it will take months—and for some aspects, years—to assess the impact.

We've been hearing plenty of reports about long waits for HIX access, server problems, and other delays. But industry observers and stakeholders—who have the proverbial skin in the game—are looking well beyond those early glitches to the impact of HIX over the long term.

"I am certain that things won't go smoothly [at first], but I envision that any glitches will be resolved in the first couple of weeks. By the end of October, I think things will be running smoothly," says Caroline Pearson, vice president of Avalere Health, a consulting group that has studied HIX.

More than 2.8 million people tried to access the federal HIX site, Healthcare.gov, on launch day yesterday. People who don't have health insurance or who have serious health conditions are highly motivated to enroll. If they encounter problems early in October, Pearson expects that they will "come back and try, try again" until they are able to process their application and get enrolled in a health plan.

To take the long view on HIX, I spoke with Pearson, as well as Joe Mondy, spokesperson for Cigna, and Steve Wojcik, vice president of public policy for the National Business Group on Health. Here are some pointers.

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