Federal and state governments have spent millions of taxpayer dollars to come up with a website through which consumers can purchase health care insurance in the open market. The federal government operates healthcare.gov. Some states have opted not to utilize the federal government's exchange and approach it on their own. This has proved to be a very costly and disastrous undertaking for some states, such as Maryland, whose situation was described in this week's introduction.

Oregon also discovered that running its own exchange can be a risky and expensive business. "Although the state has spent an estimated $248 million to get the operation up and running, it never enrolled a single private insurance customer online" (La Ganga, 2014). Oregon claims that it was not a failure of policy; the problems were in the building of the website, making the program virtually inaccessible.

With all the money spent to create these health care exchanges, the question remains: do they really work?

Consider that states are supposed to make these websites user-friendly and appropriate for a person who reads at the eighth-grade level (the typical U.S. public health standard). Reflect on your own experiences in accessing the state exchanges. It may also be helpful to get some additional feedback from friends or family members (not in the health care business) to ascertain their impressions of the websites you are evaluating. Consider the following:

• The average American's health care literacy; in other words, can they comprehend what they are reading on these sites to make an informed choice?
• What are your impressions? Is the site user-friendly? Is it easily accessible?
• What about support for people with disabilities?

To prepare for this Discussion, browse the California Health Insurance Exchange website, Covered California

Covered CaliforniaLinks to an external site.. (n.d.). Retrieved from http://www.coveredca.com/

Schoen,C,etal. (2013). Access, affordability and insurance complexity are often worse in the United States compared to ten other countriesLinks to an external site..Health Affairs, 32(12), 2205-2215.

As you evaluate California Health Insurance Exchange website, be sure to look at the 2015 Covered California Shop and Compare Tool section of the site.

Include citations.