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What The Obamacare Haters Don't Want You To Know About Exchange Successes -- And Why They Don't Want You To Know It

POSTED BY: NIKI2
UPDATED: Friday, November 8, 2013 14:18
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Friday, November 8, 2013 2:18 PM

NIKI2

Gettin' old, but still a hippie at heart...


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While the anti-Obamacare blogosphere has been hard at work highlighting the failures experienced in early days of the Affordable Care Act health insurance exchanges, there is a great deal that these folks have somehow managed to leave out of the narrative.

Small wonder—as you will shortly see—when you consider the large role these voices of doom have played in creating the very circumstances that have resulted in the launch problems they now seek to exploit.

Did you know that the State of California—taking advantage of the expansion of Medicaid that is made possible by the ACA—has already signed up some 600,000 low income Californians?

While you may belong to the school of thought that deplores the existence and expansion of the Medicaid program, one struggles to see how gaining healthcare coverage for 600,000 people in one state before the exchanges even opened can be viewed as an executional failure—even if you dislike the program itself.

As a result of the California activity, Dan Diamond reports that more than 16,300 applications were already processed in California by Saturday, October 5 with 28,699 Californians being deemed eligible for coverage.

By anybody’s metrics, this is not a half-bad first week of doing business. As California Congressman George Miller (D-CA) points out, had the launch of his state’s healthcare exchange been an IPO, it would have been one, great success.

And it’s not just California.

Did you know that the State of Kentucky—where Democratic governor Steve Beshear had to fight off a Republican controlled legislature and the obstruction of its two United States Senators, Rand Paul and Mitch McConnell—reports about 175,000 visits to their state operated exchange, with 15,000 completing applications and 7,000 already enrolled in health insurance policies in the first week?

Not bad for a state of just 4,300,000 people.

And did you know that, in the State of Washington, over 20,000 people have already filed applications on their state operated exchange?

So, why are some states doing so well while others are struggling as a result of malfunctioning computer software?

For starters, each of these states is operating their own, state created and state operated exchanges. These are not states that chose to play politics by refusing to set up their own exchanges and allowing the federal government to do it for them.

This is where the irony begins to drip like maple syrup on a Vermont morning.

In a recent article by my Forbes colleague Avik Roy, Avik suggests that he has ‘exposed’ the reason why the federally operated state exchanges are having such a terrible time with their web portal.

According to Roy, a conscious decision was made at the Department of Health & Human Services to require people to first fill in an application before allowing them to peruse pricing so that those who are entitled to subsidies would not experience the sticker shock Roy claims awaits those who will not be entitled to subsidies.

And yet, if you go to the health exchange websites in California, Kentucky and Washington—along with the sites for a number of other states who took on the responsibility to build their own exchanges—visitors are perfectly free to shop for prices and policies without having to first file an application as one does on the federal offering that Roy finds to be the result of some carefully contemplated government conspiracy.

Somehow, despite the ability of interested citizens in these states to shop before they apply, these exchanges are off to a great start with no shortage of interest among their residents. Thus, if HHS did, indeed, craft their exchange to hide the truth, it appears that it was a very unnecessary undertaking on their part.

Considering this, two things become rather clear.

First, viewing the pricing prior to applying has not hurt business in the three states profiled above, causing me to view Avik Roy’s conspiracy theory regarding the federal exchanges with a fair degree of skepticism.

Secondly, it would seem more than clear that the states who built their own systems have done considerably better than the federal government’s offering.

And yet…here comes the foul irony…it was the very same commentators who cheered from the sidelines or aggressively egged on the opposition as Red State after Red State decided to play politics by refusing to set up their own exchanges who now condemn the results of the federal effort.

If Avik Roy, and like-minded commentators who have long expressed a deep lack of confidence in the federal government, saw this coming—as they will all tell you they did—why were they not pushing state governments to take on the responsibility of building their own exchanges rather than advising them to let the feds do it?

How do you argue that you have the interest of Americans at heart and then stand by and allow the federal government to fail —when that is precisely what you say you expected to occur—if you believe that the states would do a better job?

The ACA allows the states to execute the critical mechanics of that law recognizing that, indeed, the states would likely do a better job than a ‘one size fits all’ execution by the federal government. However, expecting that a handful of states would not be able to pull it together, the law included the option of the federal government doing the job for any state that could not do it on their own.

The expectation was that states would want this control—leaving just a scant few to call upon the federal government to do the job for them.

Yet, when it became politically enjoyable for the GOP to do everything possible to block the ACA—while creating the goose that laid the golden egg for talking heads and writers anxious to stoke the anger of Americans when it comes to Obamacare—small government conservatives literally began pushing Red State governors to resist state control of their own exchanges. It was a call to inaction that Red State Republicans were all too happy to answer as, apparently, ”one size fits all” works rather nicely for Obamacare objectors when it comes to what they view as useful to their cause.

Now, the anti-Obamacare forces are screaming bloody murder over the federal efforts while quietly ignoring the successes of state created and operated exchanges and the role the anti-ACA forces played in seeing to it that things did not go far more smoothly at the launch.

The federally operated exchanges will improve. At some point, the rocky start for these exchanges will become a footnote in the history of a law that will someday be as accepted and appreciated as other programs—like Medicare, Social Security and the Part D drug plan—that were also controversial at inception.

Until then, conservative and anti-Obamacare commentators will do everything they can to keep you from seeing the role they have played in creating the very difficulties and roadblocks the law will face as it finds it’s footing.

No matter. As the program begins to make healthcare available to millions of Americans while some of the experiments in cost cutting bear fruit, the voices of doom will do as they always do—fade to the background where they will finally be lost forever. http://www.forbes.com/sites/rickungar/2013/10/15/what-the-obamacare-ha
ters-dont-want-you-to-know-about-exchange-successes-and-why-they-dont-want-you-to-know-it/


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