Sen. Max Baucus (D-Mont.) raised eyebrows across the country last month when he publicly fretted about an Obamacare train wreck as the Administration rushes to implement the many provisions of the law that take effect in 2014.
President Obama has attempted to assuage Sen. Baucuss concerns, saying that his staff was pushing very hard to make sure that were hitting all the deadlines.
But an Obamacare train wreck isnt a distant possibility. Its actively happening. Delays, wasteful spending, and cost overruns have already popped up. And its becoming increasingly likely that the exchanges wont be ready by October 1, when theyre supposed to open for enrollment. Mass confusion and excessive costs will result.
The federal government is set to operate exchanges in 27 states and to jointly run them with state officials in another seven. Seventeen states will create and administer exchanges on their own.
At least, thats whats supposed to happen. Gary Cohen, whos in charge of the implementation of Obamacares exchanges, said in March that the federal government will likely end up running some of the exchanges in the 17 states that elected to set them up on their own because they wont be ready in time.
Even the states the administration has paraded around as pioneers are having trouble creating government-run insurance marketplaces out of whole cloth. Connecticut, the first state approved to set up an exchange, is now struggling to get it up and running. Colorado is stripping its opening-day goals to a minimum.
Federal officials have struggled to come up with a comprehensible application form. Their first effort reached 15 pages. After a round of criticism, they came back with a form thats three pages for individuals and seven pages for families.
Henry Chao, a senior federal official working on the information technology that will run the exchanges, said in March that he was pretty nervous about meeting the October 1 deadline and was reduced to hoping that the exchanges dont end up being a Third World experience.
And its not as if the feds and the states have been short on money. The Department of Health and Human Services (HHS) will have spent $4.4 billion on state exchange grants by the end of this year. Thats more than double what the Department said would be necessary just last year, despite the fact that fewer states than the feds anticipated agreed to establish their own exchanges.
The agency has also asked for $1.5 billion to help fund the exchanges its setting up in states that have refused to do so on their own next year. California is planning to use $673 million in federal money to deploy 21,000 people, known as navigators, to sign people up for its exchange, Covered California. Those folks get a bounty of $58 for every person they sign up and $25 for every annual renewal.
HHS cant even account for all the grant money its throwing at the states, since the money comes with little or no restrictions, guidelines, or accountability.
HHS is not just raiding the federal treasury to promote the exchanges. Secretary Kathleen Sebelius is now shaking down corporations and nonprofits to bankroll the Administrations efforts. Shes solicited donations on behalf of Enroll America, a group headed by former Obama staffers that seeks to aid in the rollout of Obamacare.
Sen. Lamar Alexander (R-Tenn.) postulated that Sebeliuss fundraising may be illegal and has called on the Government Accountability Office to investigate.
Even if the exchanges open on time, theres little guarantee consumers will actually have insurance options, as Obamacares architects promised. Major insurers have indicated they plan to operate in less than a third of the exchanges. In California, for instance, UnitedHealthcare, Aetna, and Cigna are all choosing not to sell policies through the states exchange. This will undoubtedly reduce consumer choice.
Employees working at small businesses are unlikely to have any choice of plans in the exchanges designed for them.
The Obama Administration has delayed full implementation of the Small Business Health Options Program, or SHOP, in the 33 exchanges it will be running. Workers at small businesses were supposed to be able to log onto these exchanges and choose from among several competing plans. Instead, employees of a given firm will have just one option through the exchange until at least 2015.
The feds are permitting states to delay the implementation of SHOP in their own exchanges, too. Maryland announced that it will postpone its version for at least three months. And Washington State is considering a delay after just one insurance company said it would participate.
That lack of competition on the exchanges will yield higher prices for businesses and consumers.
And Obamacares raft of regulations and costly benefit mandates will only drive prices higher. According to a new report from the House Energy and Commerce Committee, major health insurers expect average premiums for individuals to double and in some cases, to quintuple. Small-business premiums will shoot up anywhere from 50 to 100 percent.
Of course, if premiums increase, the federal subsidies Obamacare established to keep them affordable will have to surge, too. The Congressional Budget Office recently raised expected subsidy costs over the next decade by $233 billion.
The Obamacare train is derailing right now. The only way to stop it from crippling taxpayers, small businesses, the health care system, and the economy is to cut the engine and pull hard on the brakes.