October 29, 2013
Over the past few months, implementation of the Affordable Care Act (ACA) has attempted to shift from “low gear” (inadequate to reach the final objectives) to “high gear” (in an attempt to get the job done). Many aspects of these implementation efforts have been discussed in previous postings to this blog (as indicated below).
Lack of adequate communications with the public—over three years—has given way to frenetic efforts to ramp up outreach and education.
And lack of adequate technology development has led to a glitch-filled rollout of the federal Exchange website healthcare.gov.
Both of these “crises” have resulted from failures by the Department of Health and Human Services (HHS) to adequately schedule, budget, and manage implementation activities over the years since passage of the Act. There seems to have been little or no attention paid to the preparation of a comprehensive list of tasks and deadlines from the beginning.
Regulation-related tasks were delayed, so that operational tasks could not proceed, and these operational tasks also seem to have suffered from inadequate management.
There may be some “silver linings” here.
The political drama over the ACA during the past month has brought more attention to the Health Plan, in more ways, than all of the formal outreach efforts combined.
If “any publicity is good publicity”, then the communications situation may have been improved as a side-effect of the political conflict. The Exchanges are now “front and center” in public awareness.
And the technical delays over the Exchanges may also have a positive side, as many people may begin to think that the ACA must be a “better deal”— since so many individuals are complaining about not being able to sign up for health insurance policies.
From this perspective, the more complaints rise about lack of access to the federal Exchange, the more everyone may be more inclined to participate and not to be “left out”.
So it is hard to tell what the net effect of political conflict will be—to strengthen or weaken implementation.
Attorneys may be able to assess current responses by individuals and organizations to the implementation saga by noting whether the attitudes being displayed are “all of these problems are making me/us want to avoid participating” or “all of these problems are interfering with my/our ability to participate”.
Previous installments of “The Obamacare Report” include the following topics:
- Impact of the ACA on attorneys
- Postponement of the large-employer mandate
- High-tech and low-tech for Exchanges
- Large and small-business employers
- The ACA and organizational ties
- ACA navigators
- The ACA and businesses
- Insurance brokers and the ACA
- Retail medical clinics
- Medical providers and the ACA
- Employer networking
- Data services hub
- Startup for Exchanges
- Insurance policies
- Accreditation for policies
- Winners and losers
- Impact of political drama….
More on these and related ACA topics may be found in a recent book by the authors that describes implementation of the ACA, and in a new Practice Guide by the authors that addresses funding and access issues in health care.