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September 25, 2013

Rocky start predicted for insurance program in Indiana

6-month rollout should allow for time to streamline system

— Indiana’s federally run marketplace at is scheduled to be running on Oct. 1, but don’t be shocked if it’s not fully functional on Day 1.

“My personal projection is that the Oct. 1 start will be a rocky one,” said Chris Schrader, president of Schrader and Associates in Bloomington and an expert on the Affordable Care Act. “The federal government has said it will not test the electronic system to work out any possible bugs until Sept. 30, the day before it needs to be up and running. I’m very concerned about that.”

Schrader said in most cases, a company would test a new interactive website well in advance of the roll-out date.

“Something of this size and scope should have been de-bugged six months ago,” he said. “What they’re doing is very risky. I really hope when they flip the switch on Oct. 1, everything works like a charm and when people click on icons they don’t get an hourglass spinning endlessly around, but I have my doubts.”

Schrader said if there are functional problems with the site, people can go to the U.S. Department of Health and Human Services site at to print out paper applications, then fill them out and mail them in.

Paper application forms for families start at 12 pages and grow as children are added.

“I really do expect this will be a paper process at first,” he said. “That would really slow the process down and make things more cumbersome.”

But Schrader said the 6-month-long enrollment period will give the government time to work out any possible kinks in the system.

He suggests that between now and Oct. 1, people familiarize themselves with the website, as well as several YouTube instructional videos produced by the U.S. Department of Health and Human Services.

“Those videos do an outstanding job of communicating the information at the basic level,” he said.

Schrader said even if the electronic system functions as planned, many people will have problems navigating the website and picking the best plan.

“Even employees who’ve had insurance coverage through their employer their entire working lives have a hard time understanding deductibles, co-pays and other terms,” he said. “Assuming that people who’ve never bought insurance in their lives will be able to hop onto this system, understand the terminology and choose the best policy strikes me as wildly optimistic.”

Schrader said the “navigators” that IU Health hopes to have and the handful of “certified application counselors” being sought by the city of Bloomington will certainly help guide people through the application process.

“They will inform them as best they can, but I’m concerned that many of them won’t be able to grasp the information,” he said. “And the counselors can’t make the decision for them.”

He also questions whether the navigators and counselors will be able to meet the demand for help.

“My gut tells me that the people who’ve been waiting for health insurance for most of their lives will storm the gates on Oct. 1,” he said. “I think those people will overwhelm the system at first. Then I think there might be a drop-off, with another huge rush as we get closer to Dec. 15, the last day you can buy a plan and still get coverage on Jan. 1, 2014.”

Schrader said navigators must be chosen carefully, complete with criminal background checks.

“This could be an identity thief’s dream, because he will have access to people’s personal information — addresses, Social Security numbers, birth dates, financial information,” he said. “People could have their personal information compromised very easily. On top of that, the Department of Health and Human Services says it has not yet tested the marketplaces for cyber security.”

Mary Ann Valenta, IU Health’s regional director of strategic integration of individual and business solutions, said the hospital will conduct criminal background checks on all of IU Health’s 17 state-certified “navigators,” and each of them will submit a copy of their Indiana State Police background check with their application.


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