Health exchange: still problems for a few

During the initial roll-out of the Affordable Care Act last year, the state of Washington’s Health Benefit Exchange was smooth and successful compared to other state exchanges and the federal government’s crippled website.

But one year later, the state exchange has come under fire for a new website glitch on the first day of the 2015 open enrollment period, and for being slow to fix previously known problems.

The exchange was shut down after its first two hours last Saturday because it was making inaccurate tax credit calculations. It was a frustrating, but minor error.

It’s more disconcerting that consumers have had ongoing billing problems throughout the year that have left some people without insurance for periods of time. That has caused problems ranging from simple annoying and confusing paperwork to, in some cases, an inability to obtain life-sustaining medications.

The problems are most likely to affect families with complex situations, and most often those with the lowest incomes.

And when consumers called to complain or seek help, the exchange didn’t have a good system for taking calls or tracking the ones they did receive. Many of the complaint calls went to the Office of the Insurance Commissioner and even to Gov. Jay Inslee’s office.

Those are legitimate concerns, although they should be considered in context. The state’s exchange has been among the nation’s best systems, if not the best, and it continues to work well for more than 90 percent of people using the exchange. Single people rarely have trouble shopping for plans or experience issues once they’ve enrolled.

But that’s no comfort for the few thousand people caught up in billing and payment problems. We agree with Rep. Eileen Cody, D-Seattle, who told exchange officials in a legislative hearing this week, “It’s just mind-boggling. With as much money as we have spent on this, to not have it work is just not acceptable.”

More oversight and accountability of the Health Benefit Exchange could help. The exchange is a separate, non-government entity solely governed by an 11-member board of directors, which doesn’t report to anyone. It doesn’t report to the Insurance Commissioner, who sits on the board in a non-voting capacity, or even to the governor.

The state Legislature created this structure prior to the 2012 general election allegedly because Democrats feared Republican Rob McKenna might win the governor’s race and kill the state’s support for Obamacare. Some critics now believe, in retrospect, the exchange should have been rolled into the Insurance Commissioner’s office or made a state agency reporting to the governor.

More oversight is certainly needed. State Rep. Reuven Carlyle, D-Seattle, is among those who have questioned the governance structure, and he might introduce

legislation that alters the exchange’s quasi-independent form.

In the meantime, the exchange could help itself by speeding up efforts to improve customer service. It might reconsider its rejection of Insurance Commissioner Mike Kreidler’s offer to share his proven complaint system at no change.