Part D lends perspective to the exchange rollout

I’ve generally refrained from joining the rampant speculation about the launch—and attendant glitches—of I know my limitations: I mostly stopped toying with web development when I was about thirteen and decided CSS was hard. I have zero expertise to judge the quality of IT infrastructure, and it looks like critiques to date may not be especially substantive. What’s more, HHS probably won’t offer actual enrollment numbers (for federally-facilitated exchanges) until next month, which just leaves us with tedious and clumsy traffic stats to pick apart. That’s hardly fun, and it’s not a particularly productive use of time.

But Jack Hoadley, a health policy analyst at Georgetown, asked a question that warrants attention: how did the rollout of exchanges compare to the rollout of Medicare Part D? As Sarah Kliff reported in June, the Medicare program was even less popular  than Obamacare when in went live in 2005. People don’t still talk about Part D’s glitches—but they happened. Hoadley quotes a critical news story from its launch, then adds:

Based on the Medicare Part D experience, we can experience some decline in interest in the health insurance marketplaces after this first week.  But there should be steady volume of website use, phone calls, and visits with counselors throughout the fall.  Medicare Part D then experienced another surge of interest as the December enrollment deadline for coverage to begin on the first of the year.

Glitches continued with the Part D website and call center throughout the open enrollment period.  But the program added both phone lines and customer service representatives and implemented other upgrades over the weeks.  The website – both its functionality and the accuracy of its information – was the source of ongoing frustration for its users, but it did get better over time.

By the end of open enrollment in May 2006, over 16 million successfully enrolled for drug benefits in Part D (not counting another 6 million automatically enrolled as a result of participation in both Medicare and Medicaid).  Initial glitches did not deter their enrollment.  And today, Part D enjoys widespread popularity.

The exchanges’ rocky first week doesn’t set me on edge. The infrastructure itself is a pretty ambitious technological feat and October 1 was a “wholly arbitrary” date selected by HHS for launch (not a legal deadline). It’s a good sign that they have scheduled a bit of downtime this weekend—that means there’s a game plan to fix the problems.

If the kinks haven’t been ironed out substantially in the next couple weeks, I’ll start worrying. Until then, I’m going to keep calm and remember Part D.

Adrianna (@onceuponA)

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