And by “drop-dead date,” Megan McArdle is not making a joke about ensuring that the 2010 federal health care law drops dead. Instead, McArdle argues in a Bloomberg column that the law needs a hard deadline for implementation.
My best guess is that by the time HHS officials realized that they hadn’t left enough time, the only possibilities were: 1. Ask Republicans for a delay; or 2. Launch a not-very-well-built-or-tested system upon an unsuspecting public. No. 1 would have been unpleasant for several reasons. Obviously, it would have been a huge political black eye. Republicans would probably have responded by joyously agreeing to a delay — of a year or more, which would either mean launching right before the 2014 elections or possibly never launching at all. Administration officials weren’t going to put the president’s signature achievement at risk that way.
After all, if they launched a nonfunctioning system, at least the state exchanges would hopefully work, and if enough people in the states signed up, it would be too late for Republicans to demand a rollback. They’d get the system working in a few weeks, and then everything would be fine. I’m guessing that even at the end, the senior officials didn’t realize just how bad this was.
But given that they didn’t even announce that they were taking the system down for more fixes this weekend, I’m also guessing that it’s pretty bad. Bad enough that it’s time to start talking about a drop-dead date: At what point do we admit that the system just isn’t working well enough, roll it back and delay the whole thing for a year?
Yes, I know what I’m suggesting is a major, horrible task. And I’m aware that since I opposed the law in the first place, people will take my suggestion with a huge grain of salt. Fair enough, but hear me out.
If the exchanges don’t get fixed soon, they could destroy Obamacare — and possibly, the rest of the private insurance market. The reason that the exchanges were so important was that they were needed to attract young, healthy people into the insurance system. The worry was that if insurance is hard to buy — if you have to do your own comparison shopping and then call the insurance company, and fax in some paperwork and two years of tax returns — that the young and the healthy simply won’t do it. Sick people and old people who were getting huge subsidies — and maybe the ability to buy insurance on the private market for the first time in a long while — would overcome any obstacles, because if you’re spending $15,000 a year on health care, it’s worth a lot of your time to make sure that you have insurance. But if your biggest annual health-care expense is contact lens solution, you may just decide to skip it and pay the fine.