“Applying for benefits under President Barack Obama’s health care overhaul could be as daunting as doing your taxes.
The government’s draft application runs 15 pages for a three-person family. An outline of the online version has 21 steps, some with additional questions. Seven months before the Oct. 1 start of enrollment season for millions of uninsured Americans, the idea that getting health insurance could be as easy as shopping online at Amazon or Travelocity is starting to look like wishful thinking.”

“After 2018, the future of ObamaCare’s exchanges will be all downhill. At least that’s how it looks to the Congressional Budget Office. Its projections imply that the number of people getting subsidized coverage will ramp up from the 2014 start to peak at 22.3 million in 2018, but then fall by 1.8 million over the next five years.”

“On Friday, HHS all but admitted that at least one element of the exchanges won’t be entirely ready on time: the Small business Health Options Program (SHOP) — the health insurance exchanges ObamaCare set up to serve small employers. The SHOP exchanges were supposed to be fully in place by January 1, 2014. But newly released regulations propose delaying a key part of the small business exchanges for a year: the employee choice provisions that were arguably the most significant feature of the program.”

“The Congressional Budget Office on Tuesday quietly raised the 10-year cost of ObamaCare’s insurance subsidies offered via the health law’s exchanges by $233 billion, according to a Congressional Budget Office review of its latest spending forecast.”

“HHS insists that the federally run exchanges will be online on time, but it has also continued to delay state implementation deadlines in a way that could suggest the agency is not quite as ready as it claims to be. That makes the following passage from the new federal budget baseline published by the Congressional Budget Office this afternoon rather, well, interesting:”

“The feds may not have provided an estimate of the cost of operating an exchange, but several other experts have. The results are eye-popping. According to Maryland’s Joint Committee on Health Benefit Exchange Financing, administrative costs alone will run the state an astounding $201 per person in 2015. The auditing firm KPMG recently found that Ohio can expect to spend $63 million to set up its exchange and another $43 million each year to run it.”

“A major criticism of the Affordable Care Act (ACA) is its attempt to impose “one size fits all” health policy on states with
different populations and markets. Whereas health insurance was historically regulated by the states, the ACA and
accompanying regulation imposes numerous new rules onto health insurers and employer-provided plans. Millions of
Americans will be eligible for subsidized health insurance coverage in 2014, and supposedly able to enroll in said
coverage by October.”

“Thus, as it now stands, only 14 to 16 states (plus the District of Columbia) are likely to actually be operating state-run exchanges come October, when open season begins. There may be another two or three states with so-called partnership exchanges, but the feds will be responsible for most of the major functions in those states. Indeed, the final count could be lower as some states trying to set up their own exchanges—faced with significant technical challenges and limited remaining time—give up and default to a federally run exchange.”

“Having failed to persuade 26 states that participating in ObamaCare is a good deal, the liberals behind the law are denouncing these dissident Governors as federalist hypocrites. A few critics on the right are chiming in and arguing that the 26 are inviting worse results once the feds swoop in. So someone ought to say a word on behalf of the people who run state governments in the real world and have examined the health insurance ‘exchange’ question in detail. They’ve seen enough to know that the choice to set up and run these insurance bureaucracies is not a choice at all.”

“The federal government will likely be involved in running the ObamaCare exchange in at least 30 states, 26 of which expressly declined to establish state exchanges. One health-policy expert refers to it as an ‘administrative nightmare’ for the Department of Health and Human Services. Friday was the deadline for a state to let HHS know if it planned to establish a state exchange. Thus far only 18 states and the District of Columbia are planning on doing so.”