As HIX Deadline Looms, States and Feds Scramble

"Once you begin to understand the specifics of an incoming group of new customers that is when you tailor the products in certain ways, you communicate and educate in different ways, and you help the customers navigate the system. They will require much more tailored, targeted activities by the healthcare sector than it has been forced to do in the past."

The so-called fiscal cliff, which Congress left unresolved, could prove problematic for exchanges. Lawmakers in the coming weeks and months will be looking everywhere for savings, and PwC estimates that delaying implementation of the exchanges for at least one year could save the federal government an estimated $23 billion.

"There will be some pressure on the Obama Administration to consider delay, either from players that are not yet prepared and want more time to prepare or from people that are focused on the federal deficit," Connolly says. 

"We know that delay accrues some short-term budget savings because you have one year's worth of subsidies that won't go out the door. There are going to be a lot of different ideas kicked around in the next couple of months about where to save some money, so it's going to be under discussion."

Connolly says delays would not come without a downside.