HealthCare.gov, the federal health insurance exchange, is a disaster. One month out from launch, the mother ship is still grounded and looks like it will be for some time yet. The state-level stories, however, are quite different. The Washington Post reported last week on four states—California, Connecticut, Kentucky, and Washington—that are doing pretty well at getting citizens signed up. The same seems to be true for Arkansas and Rhode Island, based on data through the first four weeks of enrollment.
The 16 states that chose to create their own exchanges have online insurance marketplaces that are independently developed, and locally hosted and operated. Consumers living in the other states go to a single federally hosted webpage, HealthCare.gov.
State-based exchanges have their share of glitches but have pretty much gotten the technology right. What they didn’t get quite right was the human factor: Both interest and demand for information about the possibility of affordable health care is “more than most states anticipated,” says Angela Sherwin, program director of the Executive Master of Healthcare Leadership program at Brown University. “Enrollments are slower than desired, but states with their own exchanges are running more smoothly in general than the feds, and they may be able to react to demand and tech issues more quickly.”