Name: Anonymous 2013-11-04 11:45
Why Obamacare rollout became stuck
WASHINGTON - The disastrous rollout of Health-Care.gov, a new federal health insurance marketplace at the heart of US President Barack Obama's signature health-care reforms, can largely be traced to a decision made 3½ years ago.
In May 2010, Mr Obama's top economic aides received a four-page memo from a trusted outside adviser warning that no one in the administration was "up to the task" of overseeing the construction of an insurance exchange and other intricacies of translating the reforms into reality.
The economic aides lobbied for the President to appoint an outside health reform "czar" with expertise in business, insurance and technology. But his top health aides, who had shepherded the legislation through its tortuous passage, argued that they could handle the job.
In the end, the economic team never had a chance: The President had already made up his mind, said a White House source.
Mr Obama wanted his health policy team, led by Ms Nancy-Ann DeParle, director of the White House Office of Health Reform, to implement the law. Three-and-a-half years later, such insularity has emerged as a central factor in the disastrous rollout of the new health-care reforms.
"They were running the biggest start-up in the world, and they didn't have anyone who had run a start-up, or even run a business," said Professor David Cutler, the Harvard University don who authored the memo.
"It's very hard to think of a situation where the people best at getting legislation passed are best at implementing it."
The project was also hampered by the White House's poitical sensitivity to Republican hatred of the Obamacare law, a sensitivity so intense the President's aides ordered that some work be slowed down or remain secret for fear of feeding the opposition.
There was no single administrator whose full-time job was to manage the project, while some outside IT companies that were hired to build the website, HealthCare.gov, performed poorly.
These interwoven strands ultimately caused the insurance exchange not to be ready by its Oct 1 start date.
WASHINGTON POST
WASHINGTON - The disastrous rollout of Health-Care.gov, a new federal health insurance marketplace at the heart of US President Barack Obama's signature health-care reforms, can largely be traced to a decision made 3½ years ago.
In May 2010, Mr Obama's top economic aides received a four-page memo from a trusted outside adviser warning that no one in the administration was "up to the task" of overseeing the construction of an insurance exchange and other intricacies of translating the reforms into reality.
The economic aides lobbied for the President to appoint an outside health reform "czar" with expertise in business, insurance and technology. But his top health aides, who had shepherded the legislation through its tortuous passage, argued that they could handle the job.
In the end, the economic team never had a chance: The President had already made up his mind, said a White House source.
Mr Obama wanted his health policy team, led by Ms Nancy-Ann DeParle, director of the White House Office of Health Reform, to implement the law. Three-and-a-half years later, such insularity has emerged as a central factor in the disastrous rollout of the new health-care reforms.
"They were running the biggest start-up in the world, and they didn't have anyone who had run a start-up, or even run a business," said Professor David Cutler, the Harvard University don who authored the memo.
"It's very hard to think of a situation where the people best at getting legislation passed are best at implementing it."
The project was also hampered by the White House's poitical sensitivity to Republican hatred of the Obamacare law, a sensitivity so intense the President's aides ordered that some work be slowed down or remain secret for fear of feeding the opposition.
There was no single administrator whose full-time job was to manage the project, while some outside IT companies that were hired to build the website, HealthCare.gov, performed poorly.
These interwoven strands ultimately caused the insurance exchange not to be ready by its Oct 1 start date.
WASHINGTON POST