The website now has capacity to handle 800,000 users per day, and 29,000 individuals enrolled in the first two days of December alone. By the end of November, HHS reported 365,000 individuals had enrolled in the federal and state exchanges, with nearly two-thirds of those in state-based exchanges. HHS is turning its attention to solving major problems with backend IT functions with conveying enrollee information to insurers. Exchanges also are ramping up marketing efforts to accelerate enrollment numbers.

Meanwhile, Healthcare.gov’s early problems could leave some currently insured with coverage gaps on Jan. 1. To date, 38 states have adopted the Administration’s option to grandfather 2013 policies slated to be canceled, but it is unknown how many policies will actually continue into 2014. High-risk pools also have provided coverage for those with health needs through state-run pools and the ACA’s Pre-existing Condition Insurance Plan (PCIP). To date, nine states have delayed transitioning high-risk pool enrollees to exchanges and the federal government extended PCIPs through January 2014.

Focus also is turning to the 2015 plan year. HHS proposed moving open enrollment by one month-to run from Nov. 15, 2014, to Jan. 15, 2015-to provide issuers more time to make decisions on participation, product offerings and rate submissions. HHS also released a notice for comment on the quality rating system for exchange plans to take effect in 2017.

This article was excerpted from the December issue of State Reform Insights.