As the Obama administration works to fix the technological problems associated with, greater issues with the federal health care exchanges remain, said a panel of health care experts Thursday in Washington.

Such issues include interfaces with insurers and the Centers for Medicare and Medicaid Services, said Elizabeth Carpenter, senior manager at consultancy Avalere Health, at eHealth Initiative’s Health Data Exchange and Interoperability Summit.

In the 36 states that have defaulted to the federal exchanges, the constant website outages can no longer be pinned on volume-related problems, Carpenter said. There are “some legitimate issues,” she said, adding it is getting close to “panic time.”

In a follow-up phone interview, Carpenter said it is not possible to pin these issues on any single thing. “There were a host of contributing factors,” she said. “Any underlying technical issues have been exacerbated by [site] volume.”

While The Department of Health and Human Services is promising publicly to have fully up and running by the end of November, “that seems like a while away,” Carpenter said. “While most of us thought there would be glitches ... it is somewhat concerning.”

Fellow panelist Caitlin Sweany, a senior manager at PwC’s Health Research Institute, questioned if carriers will be ready on Jan.1 to handle the expected influx of new claims. Problems with the launch of are beyond the scope of expected issues, she said.

At the core of the problems is untested code on the website, said panelist John Kelly, principal business adviser at Edifecs, a health care tech company. “We are in the fog of war in the middle of this,” he said of the exchange sites.

Meanwhile, Carpenter said it has been a much more positive experience on the state-run exchanges. While these sites are experiencing glitches, especially with connecting to the federal data hub, “the states seem to be managing it better” by finding workarounds, including encouraging the use of paper applications. The rollout on the state level has not been perfect, Carpenter believes, but “it has been a far more favorable consumer experience” then those run by the federal government.

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