My must read of the day is "Obamacare: So, what could go wrong next?," in Politico:
They’re mostly worst-case scenarios, and an Obamacare recovery in the next few months could still prevent some of the biggest ones from ever happening. But health care experts are taking all of them a lot more seriously now — because at this point, why wouldn’t they? […]
‘Death spiral’
This was always the worst of the worst-case scenarios: Only sick people enroll in the Obamacare health insurance plans, healthy people stay away, and everyone’s premiums rise out of control because there are no healthy people to cover the sick people’s costs.
That’s the dreaded "death spiral," and it has been a possibility all along. But it was only a remote one — because health care experts have counted on the attraction of Obamacare’s subsidies, along with the threat of fines from the individual mandate, to lure enough healthy customers to prevent a meltdown.
But they were also counting on a functioning website. Now that HealthCare.gov has tripped up all but the most committed customers, health care analysts are taking another look at the "death spiral" scenario — and some are worried that it’s already playing out before their eyes.
"This is not a political attack — I think we’re already there. I really do," said Robert Laszewski, a consultant who works with health insurance companies. "If everyone is hearing that there are all these problems with the website and you have to do all these workarounds, who’s going to do the workarounds? Sick people."
The Affordable Care Act was always flawed, for a number of reasons, but only now is it beginning to dawn on the D.C. press corps that the program’s future does not look promising.
For supporters, the biggest worry should be the canceled plans.
It was never realistic to assure the public that these plans could or would exist in the Affordable Care Act world. They had to be eradicated. Those people were needed in the exchanges. They pay for the high-risk pool.
The program was sold on at least one promise that could not be kept. Now, if the administration’s hurried fix actually occurs, the program could collapse, or the White House could be forced into a PR disaster of explaining a government bailout of insurance companies.
If they're lucky, insurers won't (or won't be able to) comply and will bring back few to none of the canceled plans.
Regardless, the administration lied to the American people in order to pass their signature legislation.
And none of this can be blamed on the Republicans. It is completely a problem of the administration’s making. That may be the toughest pill to swallow.