Will multiple states’ non-cooperation be too much for ObamaCare?

posted at 6:01 pm on November 12, 2012 by Erika Johnsen

The answer, of course, is an emphatic yes, since by its very nature, ObamaCare is too much for ObamaCare, but individual states’ freedom to opt out of designing their own state-specific health insurance exchanges is turning out to be yet another flaw in the oh-so-masterful plan.

Last week, Health and Human Services Secretary Kathleen Sebelius announced that the government is extending the deadline by which states must submit their blueprints for their exchanges, meant to be tools with which consumers can shop around for insurance options, but all states must still indicate whether they’re planning on doing it themselves, forging a partnership with the feds, or letting the federal government do it for them, by this Friday.

Certain states have been wrestling with the decision — to try and do the best they can for their state with the new normal, or let the federal government lie in the bed it made for itself? Phil Klein, among others, thinks that states shouldn’t acquiesce; Washington is going to end up making all of the really important decisions anyway, so why even invite the appearance that the states have any meaningful control over what’s going on or take any of the pressure off the feds? Several states have declared flat-out that they will not be participating, and there are plenty more with misgivings — seventeen states or more may end up fully relying on Washington for their exchanges.

Which could be kind of a major problem for the federal government; WaPo has the skinny on how much work it is to set up these insurance exchanges, and if the federal government has to manage all this… that’s a lot of bureaucrats.

“These are systems that typically take two or three years to build,” says Kevin Walsh, managing director of insurance exchange services at Xerox. “The last time I looked at the calendar, that’s not what we’re working with.” …

These marketplaces often get described as a Travelocity or Expedia for health benefits. While that might be the case for the consumer experience, experts say the underlying technology is hugely more complex, a maze of interconnecting computer systems meant to deliver health insurance to 30 million Americans.

“The reality is, states and the federal government are building something new,” says Pat Howard, who runs state health issues for consulting firm Deloitte. “There’s a rough blueprint in terms of federal regulations, but there’s still a number of decisions that need to happen to operationalize this.”

I fear that this will not end well. …So, nothing out of the ordinary.


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