The third week of enrollment in the federal exchanges opened with these strong words from one of the ACA’s biggest supporters, Ezra Klein: “So far, the Affordable Care Act’s launch has been a failure. Not ‘troubled.’ Not ‘glitchy.’ A failure…The magnitude of this failure is stunning. ”
Klein offers five takes on the ACA’s persistent rollout problems, making two especially crucial points. First, as we’ve said before, Klein notes that in shutting down the government, the GOP may have made the most self-defeating political move in recent memory. Without the shutdown, the ACA’s failures would be all news, all the time, and the GOP would be sitting pretty while anger with the law skyrocketed. As things stand now, not only is the public distracted from the ACA; many Americans who have experienced the problems with enrollment may think the law is only malfunctioning because the government is shut down.
Klein also thinks that there could be glitches that haven’t even become public knowledge yet, and if so, this trainwreck of a rollout could extend much longer than many have predicted. So far registration has been most problematic, but once those get resolved and more people create accounts and shop for insurance, the backend of the site through which that information gets communicated to insurers might start failing. Moreover, many people who think they have signed up for insurance might not actually have done so. Just how long these problems will extend is the million dollar question.
What Klein doesn’t do is put these two pieces of information together. The best case scenario now for the GOP may be that the shutdown gets resolved this week or next week, and the ACA continues to fail. Based on what the insurance insiders Klein quotes are saying, the ACA’s continued malfunctioning seems likely. The House failed to pass a new compromise to end the shutdown and extend the debt limit that had been proposed this morning. It would have scrapped the medical device tax and forced all members of Congress and the cabinet to get insurance through the exchanges without an employer subsidy. It’s not clear now what the House will do, but if something like that plan eventually does pass, and the shutdown ends, the ACA’s failures could move to center stage.
At that point, the new costs and premium rates could join the technical failures in creating the kind of opposition to the ACA that the GOP could already be enjoying. Indeed, the rates and the glitches could be linked—Avik Roy thinks the site has had traffic problems because it was designed to limit people’s ability to see the pre-subsidy price of insurance. If that’s true, even solving all the backend problems with the site won’t be enough to make the law popular in the long term. The GOP might still have an opening here, but it will have to act fast to seize it.