Hello Idaho by Robert Ehlert: ACA's rosy projections being recalculated by reality

October 29, 2013 

I really thought by the end of the month President Barack Obama's line that the Affordable Care Act is "more than a website" would prevail as the technical issues plaguing Obamacare were resolved.

But nearly a month into this grand experiment, things are still broken.

A private business facing such obstacles would have heads rolling with the pressure of investors and overseers lighting fires beneath its leadership.

This, however, is the federal government, the benefactor of endless borrowed assets and apparently more than generous opportunities to get it right no matter what the cost in money and time.

Just over the weekend, we learned:

• Subscribers in 34 states without their own exchanges - that would exclude Idaho, which does have its own - may have difficulty getting the promised federal tax credits. The ACA language presently does not allow the credits to people purchasing in federal exchanges.

• Though Idaho does not face the tax credit issue, it does face extremely low enrollment because, among other avenues, it uses the problematic federal data hub to enroll people. Goals of signing up 5,000 people per month so far have netted around 100 policy purchases, according to a Monday report by The Associated Press.

• The lagging enrollment could force the Idaho exchange to charge insurance companies more than the 1.5 percent agreed if the monthly goals of 5,000 sign-ups through March 2014 are met. If they are not met, and the percentage has to go up, who is going to pay the difference? Will it be passed on to the purchaser?

Because we are finding out new problems almost daily - and realizing this glossy glossary charade of a "product," a "marketplace" and an "exchange" is not behaving like any business we know of - it is hard to buy into this offering.

So far, the ACA has been trotted out as your typical government program - hardly the product of three years of supposed research and development.

This could be an especially hard sell for healthier younger Americans who, by and large, were supposed to be subsidizing the less healthy older Americans to make this program pencil out. If you build it, and they don't come, you've just created a mess.

Early on, the feds were adamant about the states "marketing," basically advertising the ACA and state exchanges. I don't know what the bill was going to be for that, but I do know it's going to rise dramatically to overcome the beating Obamacare and the website are taking in the "popular culture media" where young - and healthy - Americans tune in for information and entertainment.

If you are a serious government health care organization reeling from miscues, glitches and gaffes, and you are supplying the joke material for "The Daily Show," "Saturday Night Live," all daytime talk radio and nighttime talk shows, you have a very expensive public relations problem.

Idahoans and Americans in general take their health care very seriously. They don't appreciate surrendering lifelong, intensely private medical information to a databank created from 1960s-computer architecture, a fact reported on CNN on Monday.

The ACA is always going to be criticized because half of the country was not in favor of it to begin with. The Patient Protection and Affordable Care Act of 2010 garnered not one Republican vote in the House of Representatives, and it passed on the fumes of then Speaker Nancy Pelosi's assertion that "we have to pass it to know what is in it."

With a broken website, unrealistic expectations and months of investigations looming in federal and state hearings about to begin, what is going to undo the doubt and concern that must be going through the minds of the young and the healthy?

Robert Ehlert is the Statesman's editorial page editor. Contact him at 377-6437, or on Twitter @IDS_HelloIdaho.

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