Will Obamacare 'exchanges' be ready in 60 days, when enrollment begins?

Under Obamacare, people without health insurance must sign up for it starting Oct. 1, using state-level shopping exchanges. Where critics see complexity and unintended consequences, a top administration official sees benefits and progress.

A top Obama administration official is pushing back against critics of the president’s signature health-care reform law, saying that implementation is “on track” and that the law will benefit average families.

Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, spoke Thursday, just 60 days before state-level health-care “exchanges” are scheduled to open for individuals to enroll under the Affordable Care Act.

The ACA calls for individuals who lack health insurance to sign up through an exchange – with the enrollment process for 2014 starting Oct. 1 – or to pay a tax penalty if they don’t buy coverage. President Obama’s vision is that the law, known as Obamacare, will sharply reduce the share of Americans who lack insurance, due to this mandate on individuals coupled with subsidies to help lower-income families pay for coverage.

Critics, however, say the law is creating a morass of complexity and unintended consequences, including the risk that small employers will drop coverage for their workers – undermining Mr. Obama’s pledge that “if you like the plan you have, you can keep it.”

Ms. Tavenner on Thursday sparred with House Republicans over their numerous concerns related to the law.

She said the administration is ready to grapple with the administrative challenge of checking Americans’ income – to see if people qualify for subsidized insurance. Noting that there is public “confusion” on this issue, she said that IRS data would help officials quickly verify incomes for most people, and that the government is turning to the firm Equifax for confirming data.

Only in a minority of cases, where IRS and Equifax numbers don’t agree, would the government need to further review what individuals self-report as they enroll, Tavenner said.

Under the law, each state may design its own insurance exchange, in which private insurance companies compete to offer plans that meet coverage standards set forth in the Obamacare law. Alternatively, a state can let the federal government set up its exchange – a commitment the administration is scrambling to fulfill in a number of states.

Tavenner said the exchanges will help American families by offering a new degree of transparency for consumers, and by spurring competition among insurers for their business.

“If I were eligible to enroll in an exchange plan, I would be happy to enroll in an exchange plan,” she said in response to one Republican question.

Partisan views differ on the question of cost. Tavenner cited evidence of cost-containment for individual insurance plans that are emerging under the ACA, while Republicans offered statistics about surging premiums.

In some states, Tavenner said, the cost of insurance on the exchanges is still speculation at this point.

What many health-care experts agree on is that Obamacare, by itself, doesn’t resolve the longstanding question of how to tame the long-term rise of health-care costs.

Republicans also said at the hearing that some big complaints about the law are now coming from erstwhile supporters of Obama and of the ACA.

In a recent letter to congressional Democrats, three labor union leaders including James Hoffa of the Teamsters wrote that the promise of being able to keep current employer-based health benefits is “under threat.”

The letter, republished in a news report on The Wall Street Journal website, called for Congress to make “common-sense corrections” in the law. For example, the labor leaders said the law creates “an incentive for employers to keep employees’ work hours below 30 hours a week,” to avoid a health-insurance mandate – a mandate the Obama administration recently put on hold for a year.

The letter also complained that delaying the mandate represents a “huge accommodation for the employer community,” allowing businesses to postpone penalties for not offering health coverage.