Looking at coverage of the new health care law

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As a government shutdown looms and politicians fight over funding the new health care law, news outlets are picking up their coverage since Tuesday brings the beginning of insurance marketplaces.

The New York Times wrote a piece called “On the Threshold of Obamacare, Warily,” looking at some of the decisions people must weigh as they try to comply with the new law:

The insurance marketplaces that form the centerpiece of President Obama’s health care law are scheduled to open on Tuesday, a watershed moment for the Obama administration, but also a crucial turning point for millions of Americans who will finally get the chance to square the law’s lofty ambitions with their own personal needs.

While some people desperate for coverage will need no persuading to sign up, for others the decision will amount to a series of complicated calculations that would challenge an accounting whiz, let alone an ordinary human: Are the new plans less expensive or more generous than existing ones? How do premiums and out-of-pocket costs compare? Are the networks of doctors and hospitals the most desirable? Who qualifies for how much of a subsidy, and what is the tax penalty for a miscalculation?

How millions of people answer these questions over the next six months will be vital to determining whether the Affordable Care Act lives up to its name and its ambitious goal of helping more people buy the coverage they need.

Much is at stake for insurers as well: they must attract enough healthy people to pay for the care of sicker patients and price their offerings to keep premiums low enough to be competitive but high enough to be sustainable.

Bloomberg ran a Q&A story taking a look at some of the biggest issues surrounding the rollout:

While the exchanges are expected to open on time, that milestone is unlikely to settle the 3 1/2-year grudge match over the Affordable Care Act. Technical limits and a long enrollment period mean it may be as late as April before it’s clear how many uninsured Americans sign up under the law.

“Is it going to be a train wreck, a complete failure? The answer is no,” said Dan Schuyler, a director at Leavitt Partners, a Salt Lake City-based health-care consultant. “Is it going to be completely seamless and instantaneous? No. It is going to be somewhere in between.”

The exchanges are at the heart of the law’s efforts to cover more of the 48 million uninsured Americans. About 7 million people will use the system to buy subsidized insurance by the end of the first open enrollment period on March 31, according to congressional projections.

Republicans will spotlight any problem as proof the law is a disaster. Democrats say they’ll overcome technical glitches and the law will sell itself as the uninsured gain benefits. Polls show most Americans side with the skeptics.

A Wall Street Journal story looked at the different types of plans, how it might affect small businesses and the fines among other issues. It was full of deadlines, informational websites and other practical information for those who may need to buy a plan:

Another Journal story outlined what is and isn’t going to be delayed. Here’s an excerpt from that coverage.

So is Obamacare happening or not? With frequent reports of delays ahead of the Oct. 1 rollout of new health-insurance exchanges, here’s a look at some of the major delays, and a reminder of what hasn’t changed.

Still going ahead is the core of the 2010 Affordable Care Act, the exchanges where people who don’t have health coverage from their employer or a government program can comparison-shop for coverage. Those exchanges are opening as scheduled on Oct. 1 in all 50 states. Thirty-six states have entrusted all or part of their exchanges to the federal government, while 14 plus the District of Columbia are running their own exchanges. People can buy coverage taking effect Jan. 1.

So far, so good. But not all of the functions originally envisioned will be available at the launch, and requirements for larger businesses have changed.

Business mandate delayed: The law says businesses with 50 or more employees have to offer qualifying coverage to workers or face penalties. In early July, the Obama administration said this “employer mandate” won’t take effect until 2015, a year later than originally planned.

The New York Times also published another piece about how the insurance exchanges are scrambling to prepare:

The federal government, which will operate all or part of the exchanges in more than 30 states that declined to create their own, mostly because of political opposition to the law, is having readiness problems of its own. In one example, the Obama administration said Thursday, small businesses would not be able to buy coverage online through federally run exchanges until November.

Although the exchanges have been able to tap billions of federal start-up dollars and hire companies like Accenture, Oracle and Xerox to help with the work, their task has been highly complex and their time frame tight.

The web portals for the exchanges have to be able to share information in real time with insurance companies, state agencies and the federal government, which has built a “data hub” through which it can verify the income and citizenship of people applying for subsidies or Medicaid. Each portal has to undergo rigorous testing to ensure, for example, that data will flow properly, that the portal is secure and that it can handle heavy volume. Much of the testing is still going on.

And the systems likely will continue to be tested and modified as people use the exchanges and sign up for coverage. What is interesting will be chronicling the insurance companies’ abilities to make money and sign up younger, healthier customers. Media coverage will be intense leading up to Tuesday and chronicling what happens after the rollout. The overlap of business and government in this sector will make for interesting coverage going forward.