Similar to the lead-up to implementing the Medicare Part D prescription drug program, the health insurance exchanges created by the Affordable Care Act face high stakes: a skeptical public, concerns over cost, and mounting wariness about whether they’ll be ready in time for consumers to enroll. Doubts also exist about whether consumers will be able to navigate them and whether they’ll be easy enough to use.

This report draws lessons from the launch of the Medicare prescription drug plan in 2003 to put the challenges facing health insurance exchanges today in to context. The authors say that while Medicare Part D is still not perfect, those implementing the program were successful in addressing problems as they arose, which they say may also bode well for the implementation of the health insurance exchanges.