Everyone, especially those in the health care industry, waited with bated breath to see the nationwide launch of the online health insurance marketplaces on October 1st. The launch was plagued with website malfunctions and connectivity problems in some states, including Kentucky, but programs across the country welcomed people clamoring for a look at America’s new health care options. Proponents of the exchanges say that the glitches and initial setbacks are a good sign – the overwhelming traffic to the websites show that people are actively seeking health care. Health reform opponents see the initial problems as a sign that the exchanges, and health reform generally, are too cumbersome and complicated to implement effectively.

Thirty-six states use the federal computer system to run their marketplaces; the delays were more prevalent for individuals in these states. Despite the problems, more than 2.8 million people visited the federal marketplace website on opening day. In Kentucky, 24,000 people had browsed the state’s marketplace website, kynect.ky.gov, before 9:30 am. In this same time frame, 1,000 applications were processed. And while those figures are impressive, Kentucky is home to 640,000 uninsured, meaning that there are still many who will have to register with the exchange to avoid penalties in 2014.

A week before the exchanges opened, U.S. officials for the first time disclosed insurance premiums that will be offered through the federally run health-care exchanges. Many states followed suit with their own release of prices for marketplace options. Interestingly, Kentucky is still without a complete description of rates. Audrey Haynes, head of the state Department for Health and Family Services, said she “wasn’t sure how those states were able to release rates.” According to Haynes, “sticker prices” cannot be given in advance because there are just too many variables, such as age and how many people are in their household and which level of insurance they desire.

Anthem, Kentucky Co-operative and Humana are all offering individual plans on the Kentucky exchange; some states offer a wider selection of insurers. Wisconsin, with the most participation, offers thirteen different insurers to its citizens.

There are many more obstacles for the exchanges to overcome. For example, if a person signing up online in the federal exchanges is found to be Medicaid-eligible, the system will not immediately be able to transfer the application to the person’s state of residence, which is responsible for Medicaid enrollment. It will take time for these issues to be resolved.

Kentucky’s system seems to be on the right track, but it is too early to say whether success or failure is on the horizon. What can be said with certainty is that providers will have their hands full with the influx of patients who are now, or will soon be, covered through the exchanges.