In contrast to the federally operated health insurance exchange, HealthCare.gov, several of the state-run exchanges, including those in California, Kentucky, Connecticut, and New York, have been introduced fairly smoothly. Through November 12, for example, 48,162 people had enrolled in health plans and 197,011 individuals had completed applications on the New York State of Health (NYSoH) website. Most of them were eligible for private plans, and other people were enrolled in Medicaid.
What has made the New York insurance marketplace so much more successful than HealthCare.gov out of the gate? The answer, unsurprisingly, has much to do with the planning and execution of the IT aspects of the rollout.
Long before the October 1 start date, for example, N.Y. officials determined that the state's Medicaid eligibility system would have to be upgraded, noted Donna Frescatore, executive director of NYSoH, in an interview. The state hired CSC to do the upgrade, and it also contracted with the technology firm to build its exchange website and to develop interfaces with federal agencies and local health plans.
The launch of the marketplace was not troublefree, because the initial volume of visitors exceeded expectations, Frescatore said. "But within three or four days, we quadrupled the capacity and found some places where we could run the software application more efficiently." As a result, volume has not overwhelmed the site since then. Even if the number of visits increases significantly between Thanksgiving and December 15 -- the cutoff date for people to enroll in plans that begin coverage January 1 -- she is confident that the server capacity is sufficient to handle the demand.