"The exchanges won't be perfect on Day One. The underlying electronic infrastructure that communicates among HHS (Health and Human Services) and the various state exchanges won't be up and running. But will people be able to get access to health care? Yeah, and that's really what exchanges are for," said Bianchi, who represented former Gov. Mitt Romney's administration for Massachusetts' 2006 health reform legislation.
David Smith, Leavitt Partners' director of payer services, downplayed the possibility that the White House would put the brakes on the state insurance exchanges or the individual mandate.
"Politically, the administration can't afford a delay of the more critical pieces of the law and will move mountains to implement them on time while managing expectations," he said.