It’s rare that our two political parties agree on something, but for once there may be a consensus: The rollout of the Affordable Care Act, popularly known as Obamacare, has been hugely problematic. Yet explanations for the numerous setbacks experienced in the rollout of America’s new Healthcare system have been largely underreported and misunderstood. This legislation is often labeled as the defining measure of President Obama’s tenure in office, so it is not surprising that politics have obscured the practical questions in this debate. However, it’s imperative to understand the realities of the Obamacare rollout that are larger than partisan bickering in order to repair and improve the new healthcare system.
The most widely reported hiccup in the implementation of Obamacare is likely the disastrous launch of healthcare.gov, the online insurance exchange. Long loading times and error 404 messages have made for compelling television spots, but little has been done to ascertain why they occurred and if they are really that much of a disaster for the consumer. Healthcare.gov was created by a tech company from Quebec called CGI. According to an article in the Washington Post, CGI’s mission statement is to “establish relations with the client so intimate that decoupling becomes almost impossible.”
Unsurprisingly, their record of service has been shaky. CGI was pushed out of a lucrative contract with the government of Ontario to create a registry of those with diabetes in the province after they “did not meet the requirements of their contract, which was faced with many layers of delays.” Unfortunately, behavior like this is not uncommon amongst government contractors. Military contractors, such as Lockheed-Martin or Northrup-Grumman, have often produced inferior or unneeded products due to the guarantee of their government contracts.
One study by the Project on Government Oversight found that not only were government contractors paid roughly twice as much as they received in the private sector for the same services, but they also were paid nearly twice as much as federal employees. With a project as crucial and expensive as the implementation of the Affordable Care Act, it doesn’t make sense to rely on shady outside contractors.
However, the poor construction of the website may not be as critical a problem as we have been led to believe. It is possible to sign up for coverage under a health exchange on paper, through the help of a “navigator” organization, usually a local food bank or another organization working with the underprivileged. Unfortunately, the program is taking considerable time to getting started. As of the established October 1st deadline, programs in many states were understaffed, and no navigators were available in Ohio. Furthermore, awareness of these alternate enrollment programs seems to be low. Throughout the lead-up to the implementation of Obamacare, public knowledge of the program was sketchy and convoluted. A study by the Kaiser Health foundation released this summer revealed that 43 percent of Americans were not aware of the status of the ACA, or believed that it had been repealed. With such a significant portion of the country unsure of the most basic elements of the bill, it is unsurprising that they have experienced difficulty applying for the insurance it offers.
Arguably the most important problem with the implementation of the ACA is the loss of coverage experienced by a number of Americans. Contrary to the President’s promise that those satisfied with their plans would be able to keep them, large numbers of people who do not qualify for Obamacare subsidies or are currently on employer-sponsored plans have lost their coverage. However, one important factor in whether or not people lose coverage is the level of participation in the program by state governments. Obamacare offered state governments the option of setting up their own exchange program, and an ability to expand Medicaid programs for residents whose income puts them at up to 138 percent of the statewide poverty line
States that have pursued these options have seen lower rates of coverage loss, and have had an easier time signing people up for exchanges. Medicaid funding eases the burden on clients who are unable to pay for private insurers, ensures payments to hospitals that might otherwise not receive funding, and most importantly provides an option for low-income people who might otherwise have nowhere to turn. Furthermore, state-run exchanges seem to function much more effectively than their federal counterparts. It seems that a key factor in the functionality of the new system is state participation.
The factors contributing to the rocky rollout of America’s new healthcare system don’t seem to come from either side of the aisle. The Obama administration has done a woeful job of putting their legislative mandate into practice, allowing the new exchange system to fall prey to governmental inefficiency and corruption. The Republican Party, on the other hand, has framed the debate in such a divisive and theatrical way that many Americans are confused between the rhetoric about immediate repeal and the legal reality. In order to deliver quality healthcare to their constituents, red state lawmakers are going to have to get on board with the Obamacare program. After all is said and done, the law is still in its infancy, and roadblocks are bound to appear. Yet it is only through cooperation and an acknowledgement of the faults on both sides that we can implement the best possible system for the greatest number.