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Booklets outlining health insurance options for Californians is seen at a Senior Information & Resource Fair in South Gate, California September 10, 2013 .
The head of Covered California, the health insurance marketplace created by the Affordable Care Act (ACA), says it will be ready for business when it opens Tuesday, although he predicted some glitches and delays, and noted that at least one service that was supposed to be available through the marketplace will not be available until next year.
Tuesday's opening of Covered California, and similar exchanges around the country, marks a significant moment in the implementation of the ACA, or "Obamacare." Uninsured Americans will be able to shop for private health insurance in these marketplaces, and tax credits offered under Obamacare are designed to make that insurance more affordable. More than half of the estimated five million Californians without health insurance are expected to qualify for tax credits.
Most Americans are required to have insurance by Jan. 1, 2014 under the federal law , or face a fine.
Peter Lee, the man charged with creating California's online insurance marketplace — Covered California – was widely quoted last year when he said his goal was to make buying insurance "as easy as buying a book on Amazon or shoes on Zappos."
And while that’s unquestionably a noble goal, the fact is choosing a health insurance plan and all that goes with it is a lot more challenging than shopping for a pair of running shoes or the latest John Grisham novel.
In fact, a webinar demonstration for reporters last week stumbled under its own set of online streaming glitches - nothing out of the ordinary - but certainly a reminder of just how much reliance there will be on technology when Obamacare goes live before the masses Tuesday morning.
Launching Covered California is a huge informational technology challenge, says Anthony Wright, executive director of Health Access California, a statewide consumer advocacy group.
He notes that the state's computer systems will "need to work seamlessly with the federal data hub," particularly when it comes to determining who is eligible for tax credits, since they will be based on information available at the federal level.
Lee has committed more than $350 million dollars in federal funds for the technology required to create and run the Covered California website, and all eyes will be on him come opening day. Nevertheless, he says, little keeps him awake nights as he leads California through the biggest change in the American health care system since Medicare launched 50 years ago.
" I actually sleep pretty well," he told KPCC. "We are going to open our doors on October one and allow people to shop and enroll in coverage that doesn’t start until January one. And we’re going to keep on improving."
Lee says the behind-the-scenes technological integrations are so far running smoothly, with seamless connections between Covered California and such federal agencies as the Social Security Administration and the Internal Revenue Service. Links among the agencies must confirm the income information required when someone enrolls in health insurance through the marketplace.
"I’ve been spending a lot of time with the feds," he says, "and the feds are ready."
Still, Lee admits, there are bound to be glitches that need fixing and there are likely to be delays. For instance, state officials have already reported that those who qualify for California’s expanded Medi-Cal program won’t be able to enroll through Covered California’s website until sometime next year.
Covered California will be open for enrollment through March 31, 2014.