The problems at the federal government's new health insurance website are so severe that even Democrats are starting to talk about neutering a key provision of the 2010 healthcare law: the requirement that adult Americans obtain coverage next year. But now is not the time to take such a drastic step, which could lead to sharper increases in premiums for individuals. It is true that the federal government hasn't yet fixed its website's problems, but there is still time to do so before Jan. 1, the first day coverage is supposed to go into effect. The focus should remain on fixing the site quickly and signing up more people for insurance.
To implement the Affordable Care Act, about a third of the states are operating their own insurance-buying marketplaces, called exchanges, where people not covered by large group plans at work can shop for coverage. The exchanges in all the other states are operated by the federal government. And though all of the exchanges had problems with their websites when they opened for business Oct. 1 — not surprising, considering the complexity and scale of the efforts — the troubles at the federally run site, HealthCare.gov, have been more severe and enduring.
HealthCare.gov's stumbles were obscured at first by the partisan wrangling over Obamacare that shut down the federal government the same day that the new exchanges opened for business. Now, however, the inept rollout has the public's full attention, embarrassing the Democrats who had just fought off attempts to delay the individual mandate and defund the law. Some have responded by suggesting that the administration suspend the penalties for those unable to sign up for subsidized policies, which are available only through the exchanges.
Suspending the penalties is tantamount to delaying the mandate. And if there's no enforceable requirement to buy insurance, many Americans who don't need healthcare immediately won't do so. That's because, under the 2010 law, they can still get coverage after they're sick. There's already a risk that the penalties in the law aren't stiff enough to guard insurers from being saddled with an ever-sicker, costlier pool of customers, which would cause premiums to spiral upward. Suspending those penalties would only make that result more likely.
That's why delaying the mandate was a bad idea when Republicans proposed it. The variations being floated by Democrats are just as bad. If HealthCare.gov can't be whipped into shape within the next month or so, the federal government may have to pour resources into other enrollment efforts, such as the phone banks and in-person "navigators" who guide people through the sign-up process. But we're not at that point yet, and won't be for several weeks.