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Editorial: Obamacare not dead yet

BY DI EDITORIAL BOARD | DECEMBER 02, 2013 5:00 AM

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Obamacare isn’t in a great place from a public-opinion standpoint. After the botched launch of the tie-in health-care insurance site healthcare.gov and nearly 5 million canceled insurance plans, the Obama administration apologized for the errors and brought on a new head for fixing the site.

That new leader, Jeffrey Zients, hoped to have the website working for the majority of users by the end of November. And in a Sunday conference call with reporters, Zients said the differences between the old and new healthcare.gov were “night and day.”

The site can reportedly now handle up to 50,000 concurrent users and 800,000 users a day, an impressive turnaround from October’s numbers. Only 106,185 enrolled through the online exchanges during that month, with the majority of those going through state-level exchange websites rather than healthcare.gov.

So what do these new online specifications mean in terms of actual enrollment? The site should work “smoothly for the vast majority of users,” Zients said. Julie Bataille, another top healthcare.gov official, said that means somewhere “in the zone of 80 percent of users” would be able to enroll successfully.

That’s good news for the administration, as well as the American public. Considering that those not enrolled in qualified health insurance will face fines in 2014, getting the online marketplace up and running is a vital step in the law’s rollout.

Any further delay in functionality could lead to major policy problems stemming from poor enrollment, most notably the dreaded  “death spiral.” When an insurance pool doesn’t have enough healthy people to subsidize the cost of care for the sick, prices go up, more healthy people drop out, and the prices rise even more. Hence the death spiral.

Such problems are still avoidable, and an upgraded insurance exchange further reduces their likelihood.

However, in comparison with the state-run exchanges and most other Internet sites, a 80 percent success rate still isn’t good enough. When one out of every five users likely won’t be able to purchase health insurance, it’s clear more work is needed before 2014 arrives.

Though some states won’t need to rely on the website since they’ve set up their own online marketplaces, Iowa isn’t among them. The state is responsible for insurance-plan management and consumer assistance, relying on the federal government for the web component.

Despite the very public website troubles, Obamacare is not yet seen as an irredeemable failure by most Iowans.

A recent survey of potential health-insurance buyers in Iowa found awareness of the provisions of the Affordable Care Act to be generally lacking, especially among those most likely to sign up on the marketplace. While 38 percent of those in employer-covered health insurance had heard “a lot” about the plan, only 15 percent of likely healthcare.gov consumers had. And 43 percent of that group had heard “not much” about the Affordable Care Act.

Even though many hadn’t heard of the act or knew much about it, they were still favorable to its provisions — 91 percent of the survey’s respondents said they supported requiring coverage of pre-existing conditions, 86 percent were in favor of expanding preventative coverage, and 80 percent favored covering children up to age 26 on their parents’ policies.

Even as members of the public becomes wary of Obamacare on the whole, they still want it to move forward.

Ultimately, there is still time to salvage Obamacare after a fraught beginning. With fixes being implemented into healthcare.gov, the most pressing concern about the program’s launch seems to be improving. Time will tell whether the plan’s outlook will improve with the website’s technical capacity.


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