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On Oct. 1, health insurance exchanges will open for business across the United States. Our advice: wait.

That’s also the same advice you can infer from the president on down. There will be bugs. Count on it.

The always excellent Politico blog ran a story  about how federal officials are looking at the exchanges as a marathon, not a sprint. And the worst thing that could happen is if everyone in the nation who needs insurance logs on to their respective state health insurance exchange on the first day.

“There are going to be some glitches,” President Obama said, albeit he was not talking specifically about the exchanges. “No doubt about it.”

“October 1 will be an important day to raise awareness, but it is the first day of a six-month public education effort,” said Tara McGuinness, senior White House communications adviser.

At least one state, Oregon, admits it will not be ready Oct. 1. “Cover Oregon,” the state’s exchange, will not be able to enroll Oregonians without the assistance of a certified insurance broker or community group, organizers announced last month.

“It’s not going to be beautiful implementation,” Rocky King, the exchanges’s executive director, told state legislators Monday . “I’m envisioning plenty of problems. I probably will have to take the system down on the first or second day to fix it.”

So what does that mean for consumers? The very best advice is to take a breath, relax, and don’t plan on selecting a health insurance plan for the first month the health insurance exchanges are live.

There are two main reasons time is not of the essence. First, health insurance plans do not take effect until Jan. 1. Secondly, the selection of plans will remain constant.

We checked with the nation’s oldest state exchange, Health Connector in Massachusetts, which has been selling policies since 2006. There are no caps on the number of policies sold, according to Health Connector spokesman Jason Lefferts. If in the unlikely case everyone in the commonwealth wanted to buy only one policy of the dozens offered on the web site, they could do it, he said.

That said, don’t procrastinate, either. On Oct. 1, the health insurance marketplace sites go live, and consumers will have the opportunity to look at the health insurance options available and select the plan that best fits their medical needs and pocketbook.

If the Massachusetts experience in 2006 is any indication, it requires multiple visits to the health insurance exchange site (and possibly e-mails and telephone calls) before the average consumer finally selects and buys a plan, according to the Politico story.

One place consumers can turn to for advice will be their healthcare provider. Hospitals and physicians practices across the country are gearing up to be able to answer their respective patient’s questions about which policy would work best for them.

We recommend consumers head to their respective exchange website sometime after Oct. 7 with the goal of finding a plan to buy sometime in November. You might not want to wait until December to actually buy the insurance, because those who did procrastinate may very well flood the site, slowing its response (if not crashing it), in order to have insurance in place for the Jan. 1 start date.

Evan J. Albright is a contributing editor to He lives in Massachusetts. 

Posted 7:08 PM

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