An independent government agency has cast doubt on the Obama administration’s ability to meet a key deadline in rolling out the president’s controversial health-care law. Come Oct. 1, Americans are supposed to be able to sign up for coverage under the law and seek government assistance to pay for it.
In Florida, about 2 million residents are expected to be eligible for some amount of government subsidy to help pay for the cost. Coverage would go into effect in January.
But the Government Accountability Office said last week that officials have already missed some deadlines, and a great deal of work remains without much time.
While states were given the opportunity to run their own insurance marketplaces, most opted out, including states where political support for the law is strong. Florida politicians have called the law federal government overreach, and yet they left virtually every decision about the new insurance platform to federal officials.
Florida advocates are feeling some angst as enrollment approaches.
We are “concerned about reports that the Obamacare roll-out may be a little rough, but it is the start of a huge program, so some problems are to be expected,” said Bill Newton, executive director of the Florida Consumer Action Network, which supports the health-care law.
Florida considered key to program’s success
Getting the marketplaces running is a complicated effort. Officials must:
— Review and certify health plans as being qualified to sell through the marketplace.
— Recruit staff to help consumers sign up.
— Design the website and data systems behind them for enrollment.
— Figure out how to connect with uninsured Americans – most of whom, studies show, do not yet know about the marketplace or potential for federal financial assistance.
A handful of states are handling the bulk of the work for themselves, but the federal government is taking the lead in 34 states, the GAO said.
Obamacare supporters say few states are as important as Florida in determining the law’s success, because of its high proportion of uninsured residents and its sheer size. About 4 million residents – one in five – do not have health insurance. Texas is the only big state with a higher percentage of uninsured.
There are signs of movement in Florida.
The Centers for Medicare & Medicaid Services is coming to the state this week to offer the public and advocates a look into the website and call center that Floridians will use to sign up for insurance. The next step will be the selection of so-called navigators, who will help walk clients through the selection and enrollment process.
Various advocacy groups and others in Florida have applied for the role. The selection announcement is expected in mid-August, two months behind the original schedule.
Navigator training was scheduled for July, but since the navigators won’t be chosen by then, it’s clear training will also begin late. And the GAO found the training curriculum and exam won’t be ready until July or August, also behind schedule.
Federal officials apparently assumed more states would take an active hand in setting up and running the marketplaces, and set aside funding accordingly. In states where the federal government is taking the lead, grants for the navigator program are now being shared across more players, said Leah Barber-Heinz, advocacy director for Florida CHAIN, a nonprofit focused on expanding access to health care.
Consequently, Florida’s $5.8 million grant is roughly the same amount as Washington state, which is running its own exchange, but has a third of the population, she said.
CHAIN is now working with grassroots groups to identify Florida’s uninsured population and find the best way to reach out to folks, in rural communities, for example.
“Right now, there’s a lot of infrastructure-building going on and a lot of collaboration between the groups while we wait for the marketplace to open,” Barber-Heinz said. “In the end, we believe so much in this and we do believe it will work.”
Critics spotlight delays, loss of control
Conservative groups are already predicting doom for Obamacare. The D.C.-based Heritage Foundation has issued a report called “If Obamacare Collapses: How States Can Protect Their Citizens.”
“There is nothing surprising about the GAO’s assessment of administrative problems accompanying the implementation of Obamacare’s exchanges. This is the most ambitious attempt at government central planning in modern memory,” said Bob Moffit, a senior fellow at Heritage’s Center for Policy Innovation.
He anticipates “bureaucratic foul-ups … will pale in comparison to the general loss of personal freedom that comes with being locked into a bureaucratic box where they (consumers) will be on the receiving end of a vast number of decisions, great and small, over which they will have little or no control.”
Newton of the Florida Consumer Action Network has watched the progress of other states that are taking an active role in preparing for the health insurance sales and believes Florida’s leaders are partly to blame for delays in the process.
“The most accurate description of what our state is doing is passive-aggressive,” he said. “They’re doing nothing in order to watch the person they don’t like — in this case the federal government — have as much as trouble as possible. It seems like the Republicans would like to see Obamacare fail.”
POST IN DEPTH
Palm Beach Post Staff Writer Laura Green covers the economy, Medicare and Social Security from Washington, D.C. Her emphasis is Washington’s effect on Florida and Palm Beach County taxpayers.