If you're a parent, your child can't be refused health insurance because of a pre-existing condition. Your adult child under age 26 has had the opportunity to stay on your health insurance. Your preventive care and birth control have been covered fully, with no copay from you. You might have gotten a rebate from your insurance company because they spent too much on administrative costs and not enough on delivery of care last year. If you're on Medicare, you've probably seen your prescription drug costs curtailed. All these parts of Obamacare
have been in place for the last few years.
In 100 days, on Oct. 1, the next significant provision kicks in. On that day, those eligible can begin enrolling in insurance programs, with coverage beginning in January. You're eligible if you don't have insurance from your employer, or if that insurance costs too much—more than 9.5 percent of your income. Between now and then, the administration has a lot to accomplish.
There are, arguably, two big things that need to happen between now and October. The first is technical: The federal government needs to finish building the infrastructure that allows multiple government agencies to transmit information, determining whether an individual should qualify for tax subsidies. This is a really big lift that means connecting Health and Human Services, Treasury, Homeland Security and other agencies in a way that has never really happened before.
Also in the technical arena, the federal government needs to finish building the federal exchange, an online portal that most states will have their residents use to purchase health insurance. Fifteen states are also in the midst of putting finishing touches on the insurance markets they opted to run. [...]
There’s one other task on the Obama administration’s plate just as big as technological work, and that’s outreach. Even if the technological launch goes off without a hitch, that won’t be much good if no shoppers show up to the marketplace.
On the second issue, the non-profit Enroll America has launched an education and enrollment campaign, reaching out to churches, local assistance offices, anywhere people who might be eligible might turn up as well as launching a massive media campaign. That's obviously a pretty significant help. On the technical side, the
to-do list to make sure all those people being told about how to get in the program have a program to get into is huge. It includes making sure that the 17 states who are launching their own exchanges have final approval. Which means those 17 states have to have exchanges ready to start taking people on Oct. 1. In six states, the feds have to figure out a partnership with the state governments, all of which will vary. In 27 states, they have to set up the entire exchange.
That's just the beginning of the list. Sarah Kliff identifies another 40 or so. It's an awful lot of work to compress into 100 days, and much of it—thanks to Republicans—has been delayed and delayed because of litigation, because of defunding efforts, and because of just plain old obstruction at all levels. And that obstruction isn't likely to end, at least not from Republican states, since they are counting on Obamacare's first year being a fiasco to run on for 2014. In other words, it's going to be a long 100 days.