he U.S. Affordable Care Act’s mandate is simple: provide access to health insurance to uninsured residents. But delivering on the legislation’s promise proved
Only 16 states and Washington, D.C., opted to build online healthcare marketplaces, rather than use the federal exchange. The Access Health Connecticut
(AHCT) team did more than just meet that challenge. Despite an immovable
deadline, fluctuating requirements and a radically compressed schedule, the
project team exceeded federal enrollment goals and became a model for future
projects across the United States.
From the beginning, the AHCT project faced formidable obstacles: Though the
team was formed in mid-2012, it didn’t receive federal approval to start work
until December 2012. Despite that six-month delay, the federally mandated
deadline remained fixed at 1 October 2013.
“If you look at similar projects in the public sector, they’re all taking three
years,” says Jim Wadleigh, interim AHCT CEO, in Hartford, Connecticut, USA.
Instead, AHCT had just 10 months to deliver.
“I met with our federal regulators,” recalls Kevin Counihan, CEO of AHCT
during the project and now CEO of Healthcare.gov, the federal government’s
healthcare marketplace. “They heard all my plans,
and they said, ‘That’s so exciting, but we just want
you to know we frankly don’t think you’re going to
The doubts could be forgiven, given the work
that lay ahead: The health exchange had to allow
Connecticut’s roughly 365,000 uninsured residents
to compare and purchase health insurance plans.
Beyond state residents, the project had dozens of
state and federal stakeholder groups, ranging from
the U.S. Department of Health and Human Services to Connecticut’s Department of Revenue Services, Department of Motor
Vehicles and Department of Public Health.
“We had consumers, we had the federal government, we had state agencies,
“If you look at
in the public
all taking three