Obamacare Implementation Hitting a Snag

GAO finds delays are a serious concern

June 19, 2013

A nonpartisan federal watchdog released a pair of reports on Wednesday that raise serious concerns about delays in the implementation of the Affordable Care Act, commonly known as Obamacare.

Congressional Republicans seized on the reports, claiming they vindicate opposition to the law and suggest that it will not operate as designed or as the administration promised.

About 85 percent of activities required to set up small business health insurance exchanges have yet to be completed, according to one report from the Government Accountability Office.

Health insurance exchanges, Obamacare’s primary insurance delivery method, must be up and running by the end of October. "Much remains to be accomplished by CMS and states within a relatively short amount of time," GAO notes.

Delays in the establishment of exchanges and other setbacks "underscore the sad reality that the administration is still woefully unprepared for implementation despite the law being signed over three years ago," Rep. Fred Upton (R., Mich.), chairman of the House Energy and Commerce Committee, said in a Wednesday press release.

Obamacare’s implementation has proved to be a headache for the administration, as even supporters of the law have raised concerns about its progress.

Even some of the law’s architects have warned it could be "a train wreck," in the words of Sen. Max Baucus (D., Mont.), if it is not implemented correctly.

Without the majorities needed to repeal the law, as they have pledged to do, congressional Republicans have considered proposing a delay in Obamacare implementation.

Others favor allowing the law to collapse under its own bureaucratic weight and working on an alternate health care policy solution.

Democrats have recognized the political and policy pitfalls that come with a failure to fully implement Obamacare in a timely manner.

Organizing for Action, the shadowy Democratic activist group that emerged from President Barack Obama’s presidential campaign, recently stepped up its work in defending the law.

OFA and other liberal groups are attempting to sign more people up for health insurance in order to help the law function properly, but GAO reports that significant delays and impediments to implementation remain.

The Center for Medicare and Medicaid Services (CMS), a division of the Department of Health and Human Services playing a large role in implementing and overseeing the law, "has many key activities remaining to be completed across the core exchange functions," GAO found.

Uncompleted tasks involve "eligibility and enrollment, including development and implementation of the data hub; program management; and consumer assistance."

"[T]he many activities yet to be completed—some close to the start of enrollment—could suggest the potential for future challenges," GAO said. Additional missed deadlines could further impact implementation.

CMS insists it is instating policies to more effectively implement the law, but "whether CMS’s contingency planning will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined," GAO found.

Republican opponents of the law say GAO’s findings vindicate their opposition.

"This GAO report confirms our suspicions about the implementation of the health care law," said Rep. Sam Graves (R., Mo.), who chairs the House Small Business Committee.

Graves cited GAO’s findings regarding delays in the implementation of small business health insurance exchanges and delays in a program to provide outreach and training to small businesses.

"What the GAO found is what most Americans have known all along: This law isn’t ready for primetime and come October, millions of Americans and small businesses are going to be the ones suffering the consequences," said Sen. Orrin Hatch (R., Utah), chairman of the Senate Budget Committee.