What could possibly go wrong

Exchanges, either state or federal, are supposed to be one of the transformative benefits of PPACA. A highly automated, uber-efficient insurance buying experience brought to us by those mavens of technology: government. Recent stories like this has we wondering how the exchange delivered will measure up to the one promised.

From Oregon:

"Choose easy! The woman who used TurboTax to falsely claim a $2.1MILLION tax refund and went on a spending spree until she was caught

...Due to the size of the refund, her electronic claims was examined by several people within the Oregon Revenue Department. Incredibly, they approved the payout and Reyes was sent a visa card ... The revenue department processes about $7billion in tax returns each year on computer systems designed in the 1980s."

Oregon is only one of numerous states that tried and failed to upgrade antiquated computer systems. Most states are running Medicaid systems that are just as bad or worse. No private company could stay in business with the software systems the states use. And when they finally do attempt to upgrade they go tens or hundreds of million over budget and often times fail completely.

From Ohio:

"To accommodate the eligibility changes, health officials are seeking federal support to help replace a more than 30-year-old computer system that frequently erroneously denies Medicaid eligibility and causes a huge administrative burden. "The system is so old that the county case workers have to go in and modify the answer based on information they know, but that the system can't accept"

If the exchanges do stay in place after the SCOTUS ruling we better get use to them, there is a good chance we will be using the exact same system for 20-30 years, in-spite of what technology advances.