Where do we stand after the first days of open enrollment in the health insurance marketplaces (aka exchanges) created under the Affordable Care Act? What was behind the widespread computer problems, particularly on the federal exchange, and how significant will they be in the long run? What sort of risk pool will the exchanges attract, and what are the challenges in getting younger, healthier Americans to enroll? How will the relationship between Medicaid and the exchanges develop?

These are some of the questions addressed in the latest installment of the Health Affairs Conversations podcast series by Sarah Dash, a member of the research faculty at Georgetown University’s Health Policy Institute; Joel Ario, a managing director at Manatt Health Solutions who previously served as Director of the Office of Health Insurance Exchanges at the U.S. Department of Health & Human Services; and Joe Antos, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute. You can access the podcast recording here or subscribe to iTunes and listen to this recording and other Health Affairs podcasts. (Please note there may be a delay in some browser configurations while the podcast file loads.)

This is the fourth installment in our podcast series featuring my conversations with Health Affairs contributors and other health policy experts about pressing issues facing the country. In the first podcast, Gail Wilensky and Tim Jost offered an August update on Affordable Care Act implementation. The second podcast focused on health spending: Gigi Cuckler described spending projections published in Health Affairs by researchers at the Centers for Medicare and Medicaid Services Office of the Actuary, and Uwe Reinhardt and Jim Capretta reacted to the projections and offered their thoughts on health spending trends. In the third Health Affairs Conversations installment, Alan Weil, the executive director of the National Academy for State Health Policy, discussed the impending opening of the exchanges as well as Medicaid, federal-state health policy dynamics, and how our health care system might evolve in coming years.