The three-year effort to open the Obamacare health-insurance exchanges culminates today, beset by logistical delays and efforts by Republicans to shut down the U.S. government in protest.
Even states that have cooperated with the rollout, designed to enroll the uninsured in health plans, are downplaying the debut of the marketplaces to avoid having the websites and call centers overwhelmed.
“Our message is, ‘You are welcome to come on Oct. 1 if that’s what you want to do, but you might just want to wait,'” Jon Hager, the executive director of Nevada’s insurance exchange, said in a telephone interview.
The show will go on, even with a government shutdown, as the Obama administration seeks to fulfill the Affordable Care Act’s promise of medical coverage for most of the nation’s 48 million uninsured. The budget fight may actually help by diverting attention away from the rollout, said Sanjay Singh, chief executive officer of hCentive Inc., a Reston, Virginia- based software company working on the exchanges.
“Because they haven’t had the time to really put the system through its paces, they are happy to see a softer kind of launch, where the traffic will be small the first couple of weeks,” Singh said in a telephone interview.
Democratic congressional leaders who helped write the 2010 law plan to celebrate with a news conference today and the consumer advocacy group Families USA is organizing an event that will showcase people and small-business owners benefiting from the health law.
‘Ready to Go’
“Shutdown or no shutdown, we’re ready to go,” Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, told reporters in a briefing yesterday.
That’s because the Affordable Care Act relies primarily on mandatory spending, which can’t be stopped by congressional inaction on the fiscal 2014 budget. It’s the budget category used for benefits such as Medicare and Social Security.
The $1.4 trillion Affordable Care Act requires most Americans to obtain health insurance starting next year or pay a fine. To make finding coverage easier, the law set up government-run exchanges in each state where most consumers can buy plans from insurance companies with the help of tax credits.
About two-thirds of uninsured people said they plan to buy medical coverage next year rather than pay a fine, according to a Gallup poll published yesterday.
The Obama administration is seeking to get about 7 million people to buy plans through the exchanges in the open enrollment period that starts Oct. 1 and runs through March 2014.
“It’s going to be judged on Oct. 2 as a failure by opponents of reform because 7 million people haven’t signed up,” said Kevin Counihan, the director of Access Health CT, Connecticut’s exchange. “The reality is nothing like this begins with great fanfare.”
More than 900 businesses, community groups and other organizations have agreed to voluntarily promote the law and help people sign up. Retailers Wal-Mart Stores Inc., CVS Caremark Corp., Walgreen Co. and Rite Aid Corp. plan to promote coverage in their pharmacies.
Wal-Mart, the world’s largest retailer, has invited insurance company representatives to about 3,500 stores starting in mid-October to promote their plans to customers, said Dave Tovar, a spokesman for the Bentonville, Arkansas-based company.
The government also announced a contract with the Blue Cross Blue Shield Association, the umbrella organization for 37 state and local insurance companies, to sell health plans in 30 states, including three that previously had only one carrier participating in their exchanges.
People eligible for coverage can go to healthcare.gov to find their state’s insurance exchange. Prices for the lowest- tier of plans average $249 nationwide. People with incomes less than about four times the poverty level will get discounts on their premiums by way of tax credits. For a family of four, that means those with incomes of less than about $94,000 qualify for the credits.
People with incomes under about 1.4 times the poverty level may be able to enroll in expanded Medicaid programs for the poor in about half the states.
Consumers don’t have to complete their enrollment until Dec. 15 to guarantee coverage starting in Jan. 1. They may be dissuaded from signing up this month because the first premium payment to their insurer is due within 30 days of enrollment.
The Obama administration needs some breathing room, Sebelius said at the briefing with reporters. She compared the exchanges to Apple Inc.’s new mobile operating system, which the company upgraded days after its debut to correct a flaw.
“No one is calling on Apple to stop selling devices for a year or to get out of the business,” she said. “It’s a reminder that we’re likely to have some glitches. We’ll fix them and move on.”
–With assistance from Renee Dudley and Drew Armstrong in New York, Anna Edney and Mike Dorning in Washington and Michelle Fay Cortez in Minneapolis. Editors: Romaine Bostick, Andrew Pollack
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