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The Federal Government Must Run Obamacare Health Insurance Exchanges in Most States: Is this Realistic?

The central objective of the 2010 Obamacare health reform act is reducing the number of uninsured by January 1, 2014; an objective it planned to achieve with 1) Medicaid Expansion and 2) Health Insurance Exchanges.

As planned, the states would create and operate their own Health Insurance Exchanges. Open enrollment for the insurance plans offered by these state-run exchanges would begin October 1, 2013, and the healthcare coverage would start New Year’s Day 2014.

The plan has changed.

All deadlines for state-run Health Insurance Exchanges expired Friday, February 15, 2013. As it stands, fewer than 20 states will establish their own exchange. As a result, the Health Insurance Exchanges in most states will be created and operated by federally-facilitated exchanges.

Many who have consistently supported Obamacare now express strong doubt that federally-facilitated exchanges can meet this challenge.

As pointedly demonstrated during a January, 14, 2013 hearing of the Senate Finance Committee, very little is known about the status of the federal efforts to implement federally-facilitated exchanges. Volumes of federal guidance on state-run exchanges exist.

By contrast, less than 19 pages of non-specific information is the total public federal work product devoted to the type of federal exchange that is now responsible for Health Insurance Exchanges in most states.

Senator Max Baucus, the Democrat from Montana who chairs the Senate Finance Committee and was a primary author of the Obamacare legislation, probably spoke for many yesterday, demanding that the federal regulators responsible for implementing Health Insurance Exchanges promptly produce details—not simply broad promises—about the detailed plans for federally-facilitated exchanges and a specific timetable for meeting those plans.

The issue of technology alone is reason to doubt the ability of federal regulators to meet the challenge of creating operational federally-facilitated exchanges by October 1, 2014. And this doubt should be shared by all—those who favor Obamacare and those who oppose it. A Health Insurance Exchange program by October 1, 2013 will have “bugs.” But a Health Insurance Exchange program hastily slammed together and imposed on Americans before it is properly vetted is flat unacceptable.

Transparency is a word too often used. In this case, it is a very good word for what is needed. The federal regulators who have been tasked for years with preparing for the October 1, 2013, open enrollment date must immediately become transparent about the precise status of federally-facilitated exchanges. A more important domestic priority for the President does not exist. A failed Health Insurance Exchange program fatally cripples Obamacare. Those opposing the program understand, and many have made the interesting strategic choice to surrender state authority to the federal government; gambling that the Obamacare will fail

The failure of federal regulators to perform the work vital to the program’s success would be a blunder for the history books.

© Jack Edward Urquhart—February, 15, 2013.