After weeks of almost daily PR disasters for the Obama administration, the travails of the Affordable Care Act have receded from headlines—and some of the current reports are even modestly positive. What’s going on?First, website problems have shifted from the front-end of the site to the back-end. The problems users encountered when they went to healthcare.gov were one of the biggest drivers of the ACA’s bad press, and they seem now to have eased up. That doesn’t mean the website as a whole is fixed. There have been several reports about insurers not receiving accurate information about healthcare.gov purchases—or even getting no record of the purchase at all. We currently don’t know how severe those problems will be. We could be looking at a repeat of the first website disaster, or we could be looking at something much less serious.As for cancellations, the second main source of uproar, the outlook is also far from clear. President Obama’s “one year extension” for cancelled plans muddied the waters. States were divided over whether to allow insurers in their own states to offer the extension, and even then a lot of the implementation of the extension has depended on what insurers did. The extension, however, could actually make the law’s long-term prospects worse. The extension did what the administration set out to do: salve a festering PR problem. But we just don’t know yet how much that grace period has cost the administration long-term.Finally, arguably the biggest problems with the law—rising costs and network restrictions—won’t really begin to bite until well into the new year, or even later. Rate shock is an ongoing issue, and it will take some time to see if the first-year enrollment numbers for healthy people are low enough that premiums are forced up. Network restrictions will start kicking in as people who have been forced onto new plans attempt to go to familiar doctors or hospitals and learn that their plans no longer cover those providers. But since most people don’t go to the doctor frequently, network restrictions will hit people on a rolling basis, which may lessen the overall national PR impact.The Obama administration’s last-ditch maneuvers, coupled with the time it will take for many of the law’s provisions to work themselves out naturally, have created a lull in the bad press monsoon the ACA has been weathering. That lull could be interrupted at any time by more unexpected bad news, of course, or it could very well be the new status quo. But right now it seems most likely that the other shoe will drop on January 1st, when the insurance purchased on the exchange goes into effect and all of the ACA’s latent, more serious problems start to rise to the fore.
ACA Fail FractalWhy the Law's Bad Press Has Slowed Down