Daunting challenges loom as ACA exchange deadline nears

Reuters

Article Highlights

  • ACA’s mechanisms for expanded coverage can’t “exchange” a host of implementation problems immediately ahead

    Tweet This

  • Where’s the money to run federal exchanges?

    Tweet This

  • The early wave of bad news and poor outreach for the exchanges is keeping many wary and disengaged

    Tweet This

Editor’s note: The following article is excerpted from a Q&A with Tom MIller and other health policy experts, written by Jeff Overley. It originally appeared on Law360 on June 7, 2013. The full text is available here

Law360, New York (June 07, 2013, 3:29 PM ET) -- The Affordable Care Act’s fate rests heavily on health insurance exchanges set to debut Oct. 1, and while the Obama administration is vowing that the online marketplaces will be ready to go, experts say technological challenges, higher premiums and funding woes are among the many potential stumbling blocks standing in the way of a smooth rollout.

Law360 talked with a half-dozen observers who varied widely in their assessments of the prospects for success, with some predicting the exchanges will overcome minor hiccups and others warning that an administrative catastrophe is entirely possible.

Their lightly edited comments are included below.

Thomas P. Miller – Resident Fellow, American Enterprise Institute

Their official name was changed recently to “marketplaces,” but the ACA’s mechanisms for expanded coverage can’t “exchange” a host of implementation problems immediately ahead.

Will complex information technology wiring trying to integrate multiple databases in real time for the first time actually work? Expect multiple misfires and derailments.

Wider choice of health plans for employees in small businesses using the health exchanges? Postponed.

Substantial interest and enrollment by the currently uninsured? The early wave of bad news and poor outreach is keeping many wary and disengaged.

Seamless eligibility determinations that are integrated with Medicaid coverage? Doesn’t seem likely for 2014, with less than half of the states agreeing to Medicaid expansion.

Where’s the money to run federal exchanges? Expect the secretary of the U.S. Health and Human Services Department to start organizing bake sales after coercing regulated insurers to “give till it hurts” doesn’t work.

What about the wild card that could bring federally administered exchanges to a crashing halt? Two lawsuits in federal courts pose serious challenges to an Internal Revenue Service rule authorizing federal premium assistance tax credits in exchanges that are not “established by a state.”

So, it looks like full speed ahead, right over the cliff! 

Also Visit
AEIdeas Blog The American Magazine
About the Author

 

Thomas P.
Miller

What's new on AEI

We still don't know how many people Obamacare enrolled
image The war on invisible poverty
image Cutting fat from the budget
image Speaker of the House John Boehner on resetting America’s economic foundation
AEI on Facebook
Events Calendar
  • 15
    MON
  • 16
    TUE
  • 17
    WED
  • 18
    THU
  • 19
    FRI
Tuesday, September 16, 2014 | 5:00 p.m. – 6:00 p.m.
The Constitution as political theory

Please join us for the third-annual Walter Berns Constitution Day Lecture as James Ceasar, Harry F. Byrd Professor of Politics at the University of Virginia, explores some of the Constitution’s most significant contributions to political theory, focusing on themes that have been largely unexamined in current scholarship.

Wednesday, September 17, 2014 | 8:10 a.m. – Thursday, September 18, 2014 | 1:30 p.m.
Third international conference on housing risk: New risk measures and their applications

We invite you to join us for this year’s international conference on housing risk — cosponsored by the Collateral Risk Network and AEI International Center on Housing Risk — which will focus on new mortgage and collateral risk measures and their applications.

Thursday, September 18, 2014 | 2:15 p.m. – 3:00 p.m.
Speaker of the House John Boehner on resetting America’s economic foundation

Please join us as Speaker John Boehner (R-OH) delivers his five-point policy vision to reset America’s economy.

Friday, September 19, 2014 | 9:15 a.m. – 11:00 a.m.
Reforming Medicare: What does the public think?

Please join us as a panel of distinguished experts explore the implications of the report and the consumer role in shaping the future of Medicare.

Event Registration is Closed
No events scheduled this day.
No events scheduled this day.
No events scheduled this day.
No events scheduled this day.