How long can Obamacare survive with website woes?
Three weeks after the launch of HealthCare.gov, the dysfunctional Obamacare website, the Obama administration is dispatching a team of tech experts to correct the mistakes.
President Obama has promised this team will work around the clock to fix the site, which serves 36 states, but the persistent problems with the federal online marketplace risks undercutting one of the core elements of the law. On top if its technical problems, the law has to reckon with renewed political attacks.
With every passing day, the HealthCare.gov glitches do more damage, politically and practically speaking.
"I think the damage was done," Joseph Antos, a health policy expert from the American Enterprise Institute, told CBSNews.com. "It really does startle me -- I never would have guessed two-and-a-half weeks ago we'd be where we are today."
Antos contends the "tech surge" that the administration has deployed has until around mid-November to create a "tolerable" shopping experience for people before the website's flaws take a true toll on enrollment.
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Over the six-month enrollment period, as many as 7 million people were predicted to enroll in private insurance plans through HealthCare.gov and the state-run online marketplaces (referred to as exchanges). Private insurers are depending on that many enrollees -- including a fair share of young, healthy people -- to make the new market feasible. Yet now that HealthCare.gov has stymied so many people from enrolling, the concern is that only sick consumers will bother signing up.
Even Consumer Reports -- which insists it endorses the new marketplaces -- has told consumers it may be worth waiting another month before trying to use the website.
The question is, after waiting that long, will the young and healthy return to the site? Antos contended that by mid-November, those potential enrollees will be too busy thinking about the holidays.
"I would say Nov. 15 is really about it before human nature really does take over and we have such a risk selection problem that the insurance plans could have real financial difficulty in these financial markets."
John Rother, CEO of the nonpartisan National Coalition on Health Care, agreed that the website should be fixed by around Thanksgiving to avoid major enrollment problems.
"They can't have 7 million people all sign up all in one week," he said. If the website problems lasted a week or two, he added, "that's not fatal at all, but if it were three months, that would be pretty serious."
A smaller, sicker market could mean higher premiums in the years to come, Rother pointed out.
"Any insurer usually sets premiums on the basis of their current years' expenses," he said. "The inevitable result of delay and fewer healthier people is going to be higher expenses, which would lead to greater premiums."
And given that the federal government subsidizes the cost of premiums for certain low-income consumers, that could mean greater expenses for the taxpayer as well.
"Everyone has a stake in keeping the premiums as low as possible," Rother said.
Antos noted that health insurance premiums should increase to a certain degree no matter the circumstances, as they do every year. However, he contended that fewer healthy people in the exchanges doesn't necessarily translate into dramatically higher premiums -- the Affordable Care Act has put tremendous pressure on state insurance commissioners to keep premiums low. It may, however, prompt more insurers to abandon the new market.
So at best, he said, "people will have no more choices, and the rates will be higher."
As the administration attempts to fix its website, Republicans are ratcheting up their calls to dismantle or delay the law.
Sen. Marco Rubio, R-Fla., on Tuesday announced on CBS This Morning that he intends to introduce a bill that would delay the individual mandate penalty until the website has been up and running -- functionally -- for at least six months.
Antos said, "I'm dead certain the administration will not be agreeing with any changes that come out of the Republican House, in any form, on the ACA."
That said, he added, "It doesn't mean there won't be changes. The administration has demonstrated they don't need Congress to make changes."
In fact, the administration has already hinted that it may delay the individual mandate penalty on those who fail to get insurance for at least a month.
Antos contended that at just $95, the IRS fine in 2014 for failing to purchase insurance doesn't mean much. The "mandate," he said, is more effective as a social engineering tool that could convince members of society, young and old, that they have an obligation to purchase insurance. That, however, has been completely undercut by the flawed website.
In spite of all the problems so far, Rother said he's optimistic the administration could turn things around quickly enough. He pointed out that some state-run exchanges, such as those in Kentucky and Washington State, have been relatively successful so far.
"The fact the states are doing it, and doing it well, does imply this is fixable," Rother said. "It's really unfortunate, but this was avoidable. If worse comes to worst, it seems the federal system could simply copy what the states are doing and be quite successful."
