Kingsdale says that in Massachusetts, a reliable Web site was only a modest worry. (Disclosure: Kingsdale and I once worked for the same employer and knew each other. But we haven’t spoken for many years.) Much harder was getting “enrollment, billing and premium collections working smoothly.” Here’s why:
“Enrollees are not covered until their first month’s premium is received. In the individual insurance market, premium billing and collection [are] difficult to track. Folks frequently pay late or in weekly installments, or send too little or even too much. And when they stop paying, they often do not notify the insurer; the company must determine whether it is an intentional termination, an oversight, or a lost or late payment. . . . If insurers cannot track and collect premium dollars each month, the extra work of doubling back with customers and insurers will frustrate consumers and delay coverage. And a mounting backlog could eventually compromise the fiscal integrity of the exchange.”
Translation: Assuming the Web site is completely fixed, Obamacare’s woes could still slow its introduction or, at worst, result in its collapse.