If you've been reading all the Obamacare stories lately, you might get the impression that the administration has just realized it will not be able to implement the massive health reform as designed.
It has known for months. As far back as March, a top IT official at the Department of Health and Human Services said the department's current ambition for the law's new online insurance marketplaces was that they not be "a Third-World experience." Several provisions had already been abandoned in an effort to simplify the administration's task and maximize the chances that the new systems would be ready to go live in October, when customers are supposed to start signing up for insurance.
In April, several consultants focusing on the new online marketplaces, known as exchanges, told National Journal that the idealized, seamless user experience initially envisioned under the Affordable Care Act was no longer possible, as the administration axed non-essential provisions that were too complex to implement in time. (Read the story for some examples and commentary.) That focus has intensified lately, as officials announced that they would not be requiring employers to cover their workers next year or states to verify residents' incomes before signing them up for insurance.
"There's been a focusing in not on: 'What is the full ACA vision?' but: 'What are the pieces we have to get running by October 1?" said Cindy Gillespie, senior managing director at McKenna Long and Aldridge, who is working with states and health plans.
To get a sense of what the Obama administration is up against, take a look at this chart, provided by Dan Schuyler at Leavitt Partners, a consultancy helping states build exchanges. (Bear in mind, this chart is supposed to simplify and explain.)
