Healthcare Exchanges Open for Business

The online marketplaces created by the Affordable Care Act, where individuals can purchase health insurance, opened for business on October 1, 2013.  The first week of business has provided some clues about the challenges that the exchanges will face going forward.

For Union plans evaluating competition from the Healthcare Exchanges, the difficulties that some users have faced using the Exchanges may mean that individuals and employers will be less eager to try to change their coverage. Additionally, the wide cost variations will make direct comparisons difficult, especially for Union plans that cover large geographic areas.

Technical Difficulties

Many states reported substantial difficulties with the online shopping and enrollment procedures. For the 34 states that will use the Federal exchange (, the initial traffic appears to have overwhelmed the websites, and multiple reports described either complete inability to access the website, or failures partway through the registration process. Through the first 24 hours, the Federal Exchange recorded 4.7 million unique visitors, but insurance companies reported that very few individuals had actually enrolled for coverage.

There have also been reports of technical difficulties from the 16 states that have created state-run exchanges (including California), although not on the scale of the federal exchange. In California, the exchange ( received half a million unique visitors on October 1, which led to the exchange shutting down for several hours to make technical fixes. Similar glitches were reported in other state-run exchanges as well.

There have also been reports of look-alike web pages that resemble the Exchanges in name and appearance.  These sites generally seem to be attempts by insurance companies to market insurance, but could also be more malicious efforts to obtain individuals' personal information.

Cost Variations

With the exchanges fully active, rate information is now publicly available for all states. Anyone may now see the cost of a given plan that reflects the age, household size, and location of the shopper. These plans, however, demonstrate a surprisingly large range of costs. An analysis by Kaiser Health News found that one plan from the same insurer varied in cost between $395 and $614 per month, depending on the location. Similarly, the average cost varied significantly across the country.  Additionally, different insurance companies often offered very different costs for comparable coverage in a given locations. For example, in Cook County, IL, the cost for a midlevel plan for a family ranges from $582 to $1,108 per month, depending on the provider.

For more information about the Affordable Care Act and Healthcare Exchanges, please contact your Trust Fund counsel.

By Daniel Brome | October 8, 2013

Legal Developments