Yuval Levin has done some must-read reporting on the how the Obamacare exchanges are doing so far at National Review Online. Even given what you know already, it’s shocking:
The tone of the CMS officials who spoke with me was a kind of restrained panic.
What is the CMS? Boy, you’d better get up to speed on the ABC’s of the present era pronto. When the protesters show up with the CMS = NSA = IRS signs, you won’t even understand their point!
The CMS is the Center for Medicare and Medicaid Services, the Health and Human Services agency that is running the health insurance exchanges that are the heart of the envisioned Obamacare system.
Here are a few things Levin has learned from talking with them, and insurance industry officials:
CMS officials and the large insurers thought at first that the garbled data being automatically sent to insurers must be a function of some very simple problems of format incompatibility between the government and insurer systems, but that now seems not to be the case, and the problem appears to be deeper… …the system will not be able to function if the insurers cannot have some confidence about the data they receive.
…If the problems… …are not resolved by mid-November and the flow of enrollments at that point looks like it does now, the prospects for the first year of the exchanges will be in very grave jeopardy…
…It is not a situation where it is impossible to buy coverage but one where it is possible but very difficult to buy coverage. That’s much worse from [the insurance companies’] point of view, because it means that only highly motivated consumers are getting coverage.
And who might those highly motivated consumers be? Persons already beset by health problems. Great business model!
So here’s Yuval on the big picture:
I didn’t think the system wouldn’t work because the government couldn’t build a website, but because the basic health economics involved is deeply misguided… So these problems only seem like a prelude to other, larger problems. But Obamacare was also always going to be a test of the sheer capacity of the administrative state to actually do what it claims the authority and ability to do.
And on the immediate, presently panic-causing, little picture:
My gut sense after listening to these insiders, for what little it’s worth, is that it’s not likely that the situation will prove to be much worse than it now seems, and it’s more likely that it will prove to be less bad than it now seems.
Because the present situation seems unbelievably bad!
Moderate Democrats so-called, third-party libertarians, stay-at-homers, our thanks.