Thursday, November 21, 2013

The country's biggest political debacle in 100 years

Ace has a post up on all the Obamacare problems.   Short version: a political shitstorm is just getting started, the likes of which we haven't seen in our lifetimes.


Let's review. Obamacare's problems:

(1) The website is broken.

(2) The payment and accounting and administration back-end is unwritten, untested, and out of time.

(3) They are seriously out of time to do something about those 3.5 to 5 million people whose insurance has been cancelled. To be covered by Jan 1, they have to get a new plan by Dec 15, which means 140,000 to 200,000 of them need to be enrolling every day between now and then, including weekends and the Thangsfrickingiving holiday, which ain't gonna happen ya'll.

(4) Adverse selection a.k.a. the death spiral a.k.a. the shit spiral is coming. See Ace's post last night on the Kentucky exchange's obvious precursor to the shit spiral.

(5) Next year we get to do this same song and dance with the group plans as the employer mandate kicks in.

(6) Lawsuits. There are some nontrivial lawsuits pending including the contraception mandate challenges and the suits based on the fact that the statute doesn't actually allow HHS to offer subsidies on the federal exchange or impose the employer mandate on states that didn't implement their own exchanges.

(7) There are still 40 million uninsured Americans according to President Obama. Which seems to me to be just a bit of a failure of the aims of Obamacare.

[8] The plans on the exchanges likely will not let people keep the provider networks of doctors, hospitals and specialists they currently use, making continuity of care impossible. [Andy]

[9] Obamacare appears to be nothing more that an enormous expansion of Medicaid, the worst-performing health program in the country. [Andy]

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