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Health Care Reform:

Health Insurance & Affordable Care Act

Will Low Online Enrollments In The Fall Hobble The Health Law?

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A: Because a quick solution for signup bottlenecks seems increasingly unlikely, those buffers could become more important. Even with extremely low first-year enrollments, some experts argue they could keep prices stable until portals are fixed for a smooth launch in 2015.

“In the long run, our view is that the exchanges and the entire ecosystem are going to be fine,” said Bryce Williams, a health benefits and technology consultant at Towers Watson. “But you’d have to talk about a two- to three-year horizon.”

Successful websites and signup efforts in big states such as California and New York will show that the online marketplace can work and should lead to acceptance elsewhere despite short-term problems, said James Morone, a political science professor at Brown University who specializes in health policy.

“Bottom line: No, they won’t be working” soon, Morone said of many marketplace portals. “And double no, they are not going away.”

Q: How badly do Web failures threaten other aspects of the Affordable Care Act?

A: The health law didn’t just offer commercial insurance on the Web. It expanded Medicaid for low-income consumers in states that chose to accept it. Because the programs have years of enrollment experience, Medicaid expansion is progressing better in many states than efforts to expand access to private insurance.

While the federal site “has been nowhere near as easy to use and efficient as anybody would have dreamed, we’re hopefully in the early innings” of the larger goal of expanding coverage, said Bob Kocher, a partner at venture capital firm Venrock and a former Obama health adviser.

Nor may Web problems have much effect on the health law’s other grand goal of containing costs and making care safer and more efficient.

“Accountable care organizations” that reward better care have been formed across the country. Medicare is penalizing hospitals with too many readmissions of recently discharged patients.

Online government insurance portals have inspired similar, private sites that are transforming employer-sponsored coverage.

“The notion that one website associated with one part of the law is up late - that the whole law should be thrown out - is an extreme reaction,” said Alan Weil, executive director of the National Academy for State Health Policy.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.

Thu, Nov 14 2013

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