Sally C. Pipes: Obamacare's exchanges are on a collision course with reality
More than three-quarters of Americans know “little” or “nothing” about the state-based exchanges, according to the Kaiser Family Foundation.
Scheduled to open for enrollment in October offering coverage that takes effect in January, Obamacare’s exchanges were supposed to be technocratic masterworks. They’d bring together insurers in one, simple, online marketplace. Consumers and small businesses could choose from among several health plan options. “Managed” competition among participating insurers would help keep costs low for shoppers — and hold down public spending on subsidies for purchasing coverage.
Take enrollment. The Department of Health and Human Services’s first effort at an application clocked in at 21 pages for a family of three. After a public outcry, the Department spent stacks of taxpayer dollars on high-priced consultants to teach them how to make the form simpler. In late April, they proudly presented a redo that was only three pages.
It’s precisely this kind of complexity that’s going to scare consumers away from the exchanges. And consumers aren’t the only ones fleeing. Insurers are increasingly opting out of the exchanges — uncertain about the regulations they’ll face or whether there will actually be any customers for them to sell to.
With fewer plans on offer, the exchanges are going to be significantly less competitive than planned. That means higher prices for enrollees.
The exchanges have gotten off to such a bumpy start that even Obamacare’s most vehement supporters are hedging their bets. Henry Chao, who’s officially in charge of the exchanges’ technology apparatus, recently told Congressional Quarterly that he’s “pretty nervous.”
Sally C. Pipes is president, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her next book, “The Cure for Obamacare” (Encounter), will be released this summer.
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