The health exchanges, central to the
law, are also its biggest mystery.
“You might want to avoid signing up on Day One.” In the offices
of certain government officials and health insurance companies, a ticking
countdown to a specific date has been posted on the walls for months: Oct. 1.
That’s the day of the official ribbon-cutting for the exchanges created by the
Affordable Care Act (commonly called Obamacare), when Americans can begin
lining up for 2014 health insurance. But because the law’s future was uncertain
in mid-2012, the exchanges have been scrambling to get ready for opening day.
Thirty-six states declined to set up their own exchanges for 2014 (each state
has just one), so federal health officials had to do it instead — cramming
years of work into a tight time frame. “Some people we’ve talked to will count
it as a victory if the lights come on Oct. 1,” says Eric Johnson, a Columbia business
professor and co-director of the university’s Center for the Decision Sciences.
(On Thursday, the administration acknowledged that the small-business section
of the exchanges in those 36 states wouldn’t be able to accept online
applications until November, and some of the states running their own exchanges
may also be running behind, having not yet announced when they will open to small