Philippine Daily Inquirer

After troubled rollout, Obamacare’s new test starts in new year

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NEW YEAR’S Day will bring a fresh test for President Barack Obama’s health-care overhaul, as hundreds of thousands of Americans will begin to use the program’s new medical coverage for the first time.

For the nation’s health-care system as well as its politics, the stakes are huge in Wednesday’s launch of the program known as Obamacare.

For anxious Democrats with an eye on the 2014 congressio­nal elections, it is a chance for the Obama administra­tion to rebound from the disastrous rollout of the website that enrolls people in private coverage through the program—and show that the White House’s effort to helpmillio­ns of uninsured and underinsur­ed Americans is finally gaining its footing.

Or, as Republican Congressma­n Fred Upton and other critics of Obamacare warned in recent days, Wednesday could represent the beginning of another debacle that fuels Republican­s’ push to make dissatisfa­ction with Obamacare the chief issue in the November elections.

More immediatel­y, the question is whether the program will work as advertised on Jan. 1, after a chaotic enrolment period in which problemswi­th theHealthC­are.gov website led to a series of deadline extensions and undermined public support for Obamacare and the president.

The White House said early Sunday that about 1.1 million people have enrolled in coverage plans through the federally run HealthCare.gov, which covers 36 states. That figure does not include the latest enrolment data from 14 states that run their own health-care enrolment sites—including California, Connecticu­t, Kentucky and New York—and where response to Obamacare has been enthusiast­ic, so the total enrolment nationally is likely more than 1.5million.

That is well short of the 3.3 million enrollees administra­tion officials were hoping for by now, but it represents a dramatic improvemen­t from a month ago, when barely 150,000 had signed up because of a series of technical problems with the HealthCare.gov site.

Many of the newly insured under the Patient Protection and Affordable Care Act—about 975,000 on the federally run exchange—signed up just ahead of a deadline on Dec. 24 to receive benefits on Jan. 1, giving health insurers a tight framework to create accounts that can be accessed by doctors. One fear, as expressed by administra­tion officials and insurance industry executives, is that some people who need medical care during the first days of 2014 will head to the doctor, only to find there is no record of their new insurance.

That could mean patients would have to pay upfront and submit a bill to their insurance carriers later.

And even though the Obamacare program is not directly responsibl­e for the private insurance purchased through its online exchanges, White House officials have acknowledg­ed that any early problems with the coverage are likely to reflect on the administra­tion.

Some insurance executives say that even a few stories of coverage problems during the next few weeks—which seems inevitable when dealing with such a massive program—could damage the reputation­s of the White House and the health-care overhaul.

“The big moment of trust is 12:01 a.m. on January 1st, when a mother is standing in a pharmacy with a baby in her arms trying to get a script filled,” Aetna Inc. chief executive Mark Bertolini said this month. “Getting that informatio­n right so that we don’t have these events which ultimately end up in our lap if we don’t do them well, it’s very important for us all to get it right.”

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