HIX Bedeviled By Tech, Resource Hurdles

Scott Mace, for HealthLeaders Media , July 23, 2013

Still, I didn't come away with much confidence that the system will work as intended on day one. You don't just stand up a Data Hub of this size and scope with millions of fields of tax data securely flowing back and forth between two massive federal agencies who've never done such a thing before, without problems.  

Then add the fact that 15 states will be operating their own health insurance exchanges and exchanging such information with the IRS, HHS and DHS, all simultaneously with expected response times of 5 to 8 seconds, and there are bound to be errors, and probably data breaches.

Hege and many House Republicans point out with alarm the law's requirement for employees to report changes in their income within 30 days, to allow appropriate adjustments in health insurance refunds from the IRS. Federal officials note that those requirements will be relaxed, that such adjustments could be rectified finally at tax time without penalty. Fraud concerns, though not brushed aside, were mostly left to be addressed another day. It just adds to the formidable complexity of what we all acknowledge was a formidably complex law.

Obamacare will have many do-or-die moments, and October 1 is surely one of them. Sequestration continues to sap budgets at IRS and HHS. If the health insurance exchange system gets up and going on Oct. 1, from a system integration and agency coordination point of view, it will surely be something of a miracle.

Scott Mace is senior technology editor at HealthLeaders Media.
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