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Tag: Kevin Walsh

In the Eleventh Hour

The stories you’re hearing about lamp-lit, midnight pow-wows taking place in state offices are true. The states are working around the clock at a feverish pace to meet the Health Insurance Marketplace go-live date of Oct. 1, 2013. From conversations with my counterparts who are leading the marketplaces, I understand that some of the most significant concerns include:

  • System of Record: For states building their own marketplaces, the first design decision is around the system of record. Some states are electing to use the HIX itself as their eligibility system of record, funneling all eligibility determinations – tax credits, cost-sharing reductions, Medicaid, Children’s Health Insurance Program (CHIP) and Basic Health Plan – through one platform. Other states are designing their marketplaces as entry points, from which eligibility decisions flow to a legacy system for determination decisions. Either way, states are finding that the project is akin to remodeling a 747 while it’s in the air. The legacy systems need to be updated so they can coordinate and speak to the HIX. That’s a massive undertaking on its own, but it also has to be done while the HIX is still being designed.
  • The Federal Hub: State marketplace leaders are also considering the readiness and functionality of the federal hub. States will be required to check in with the federal hub for applicants’ immigration status, income level, etc. The federal hub is being built and rolled out at the same time that states are designing the rules for how their marketplaces will speak to and integrate with it. Again, it’s a bit like remodeling an airplane mid-flight.