“The system needs to be operating reasonably efficiently — I’m not saying flawlessly — before the middle of November,” says , the insurance commissioner of Kansas, one of the 36 states relying on the federal marketplace because legislators there opted not to create their own state-based market. …

“If we’re not seeing a substantial improvement in the next two or three weeks, we’ll be in a bad place,” said , director of exchange technology at Leavitt Partners, a consulting firm. “We’re already behind the curve in getting to that 7 million mark.”
No envelope backs required for this health care calculation.

The risk in frustrating consumers is that those who are healthy or on the fence about enrolling may give up, leaving only the unhealthy motivated enough to persevere. That could drive up premiums in future years, potentially leading to what experts call “a death spiral,” where only the sickest people sign on.