Obamacare is falling apart before our eyes. The long-term care insurance program known as the CLASS ACT was deemed financially unworkable and shut down by the administration's own actuaries. Taxpayer-funded health care cooperatives never got off the ground and were shut down in the fiscal cliff deal. Last month the federal Pre-Existing Condition Insurance Plan stopped accepting enrollment applications. This week 79 U.S. senators, including 34 Democrats, voted to repeal the law's medical device tax. Premiums in the individual and small group markets could spike as much as 116 percent next year. The wheels are already wobbling and the worst is yet to come.
The exchanges at the heart of the new Obamacare entitlement are slated to be up and running for open enrollment beginning October 1. Millions of Americans will be dumped into these exchanges by employers dropping coverage and millions more will be forced to enter the exchanges by the individual mandate. But will there actually be functioning exchanges for them to go to? Maybe not.
The Obamacare law was written to incentivize states to do the heavy lifting of setting up and running the exchanges, which are administratively and technologically complex. But more than half the states said no thanks, looking at the proposed regulations and long-term operating costs and choosing to let the feds try to administer their own mess. And the states that did choose to play ball weren't able to make much progress because the Obama administration stalled key regulations until after the election.
Now the feds are rushing to get the exchanges ready.
"We are under 200 days from open enrollment, and I'm pretty nervous,'' confessed Henry Chao, the deputy chief information officer on the Centers for Medicare and Medicaid Services - which is setting up the federal exchanges. "The time for debating about the size of text on the screen or the color or is it a world-class user experience, that's what we used to talk about two years ago," Chao said. "Let's just make sure it's not a third-world experience."
So don't be surprised if open enrollment doesn't start October 1 as planned. And when the exchanges are up and running, what plans will be available to purchase through them? One effect of stalling the regulations past the election is that the choices offered in most states will be meager simply because there isn't much time to develop plans and make sure they are compliant.
The plans that are offered are going to be expensive because of the law's mandates and regulations. Every major insurer is now warning of a huge spike in premiums, especially for younger, healthier people who can no longer be offered significantly lower rates than older people who use more health care. Some people may get subsidies to help pay - after filling out a 21-page form - but others will find their families ineligible for subsidies unless they stop working full-time or, believe it or not, get divorced.
Democrats want to believe that the future of Obamacare was secured by President Obama's reelection. But if implementation ends up being the disaster that looks increasingly likely, the American people will have the final word.
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