A month before the final passage of his health care law, President Obama convened a summit the Blair House. During the staged event, which was aimed at resurrecting the bill, he touted the legislation's insurance exchanges. Obama said, "[I]f you join one of these exchanges, you will have choice and you'll have competition. You will have a menu of private insurance options that you'll be able to purchase ... "
Senate Finance Committee Chairman Max Baucus, who authored one of the bills that would eventually become Obamacare, concurred: "What I like about exchanges -- it's like Orbitz, it's like Expedia. You go to Orbitz or Expedia to buy an airline ticket, you compare it to get the best price -- that's basically what this is."
Three years later, and just months before the exchanges are set to be operational, the Obama administration is starting to lower expectations. Dramatically.
"The time for debating about the size of text on the screen or the color or is it a world-class user experience, that's what we used to talk about two years ago," Henry Chao, an official at the federal Centers for Medicare and Medicaid Services who is overseeing the technology of the exchanges, said at a recent conference. "Let's just make sure it's not a Third-World experience."
Chao also described himself as "nervous" about the short timeline to get the exchanges up and running. His comments, which came at a policy meeting of insurance industry lobbying group America's Health Insurance Plans, were first reported by CQ HealthBeat and picked up by Avik Roy at Forbes.
Regulated insurance exchanges would allow eligible individuals to use government subsidies to purchase insurance coverage. The exchanges are central to the law, accounting for about $1 trillion of new spending over the next decade. By 2023, the Congressional Budget Office projects 25 million Americans will obtain coverage through the exchanges.
But implementation is proving to be challenging, hence the panic among the bureaucrats. Though benefits don't kick in until Jan. 1, the exchanges are theoretically supposed to be available for open enrollment by Oct. 1 -- or about six months from now. Also adding to the Obama administration's workload is the fact that 26 states have opted not to set up their own exchanges, allowing the federal government to do it for them instead.
Baucus' vision of creating the Expedia or Orbitz of government-subsidized health insurance, in which a government database verifies eligibility instantaneously, now looks like a distant dream. But hey, as long as it beats Somalia.