Having trouble signing up for Obamacare?


The rollout of the federal health care exchanges has been a bust. But the real test of Obamacare comes a year from now.

Putting together a website is something so many organizations do. I can tell you from running clark.com, it is a hard business to get right when you need to design and re-design things. But when you have the resources of the federal government behind you, you would hope that you could get it right, if not on launch, then at least a few weeks after!

The GOP handed the president such a nice gift through all the drama with the shutdown and the debt limit. Why? Because it took away attention from the fact that the health care exchanges are not working. A lot of state exchanges work well, but the federal exchanges have been a bust.

What should you do if you’re an individual or small business in need of health insurance for 2014? Nothing. You now have until Dec. 15 to buy coverage for 2014.

Let the high level focus and money that’s now been unleashed on the problem work its way through the system. Just sit back, relax, and don’t bother trying the HealthCare.gov website until further notice. I’ll let you know when the bugs seem to be out of the system.

The real test for Obamacare comes a year or so out: Do the published health exchange rates hold, or do we go into a death spiral with higher premiums because of what’s called adverse selection?

Adverse selection means, in this case, a situation where only the really sick buy insurance — and the healthy don’t buy into the system. If that were to happen, the actuarial math would not support the premium structure and it will fall apart.

Meanwhile, nobody knows how it will work when you can’t charge a 65-year-old person any more than 3 times what you charge a 21 year old. The math requires a lot of subsidy to make it work. And what that all adds up to is unknown at this point.

Yet at the same time, the exchange mechanism itself is very smart and a good free market tool. That’s why private employers are doing private exchanges where you get a voucher from an employer and a list of plans you can pick from. Though they have nothing to do with Obamacare, of course.

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