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October 21, 2013 2:56 PM The Real Gut Test for the Obamacare Exchanges

By Ed Kilgore

There’s no real need to dwell too much on the president’s remarks about the Affordable Care Act today. He did what he needed to do in acknowledging (and deploring) the problems associated with healthcare.gov, the insurance exchange enrollment website, and to promise immediate action to fix them. He also reminded people, as defenders of Obamacare always should, that there’s much more to ACA than the insurance exchanges.

But the real gut test is whether the problems can be fixed before they begin to systematically discourage “less motivated purchasers”—i.e., young and health people essential to the balance needed to keep down premiums in the exchanges—from participating. I mentioned this issue last week, but today Ezra Klein puts it simply:

The nightmare scenario looks something like this: The web site continues to be a mess through the fall. As such, only the people who need insurance most - -older, sicker people — go through the trouble of signing up. Younger, healthier people come once or twice and then never again. The risk pools fill with more expensive applicants and, in year two, premiums spike. The result is that, 12 months from now, Obamacare has a working web site, but a more costly, less appealing, product.

It’s obviously impossible to know now whether and a what pace that might happen, so efforts to come up with some “deadline” for fixing the website problems are probably a waste of time, except in terms of political perceptions. And on that front, the administration is probably lucky: not only are polls showing no deterioration in (or perhaps even enhancement of) public support for Obamacare, but a lot of people probably assume the GOP-engineered government shutdown caused the website problems. That’s not accurate, but it’s certainly a bit of ironic blowback the GOP richly earned.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.

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