We’re Not the Only Ones Worried about an Implementation “Train Wreck”

From the National Assoication of Health Underwriters, April 19:”

A top Senate Democrat changed his tune a little bit this week
concerning PPACA. During a Senate Committee on Finance hearing, Senator
Max Baucus (D-MT), the Committee’s chairman, expressed some serious
concerns regarding the Obama Administration’s handling of the
implementation of the health reform law he helped to draft.

HHS Secretary Kathleen Sebelius testified on behalf of her
agency and the president’s budget proposals in front of the Senate
Finance Committee on Tuesday. During Sebelius’ testimony, Senator Baucus
questioned her on the implementation efforts of the law, state exchange
preparedness and employer and small business knowledge. Despite the
secretary’s efforts to reassure the committee that exchanges will in
fact be set up and ready for open enrollment come October 1, 2013,
Senator Baucus expressed his fears that unless the administration
improves its outreach efforts to businesses in particular, health reform
implementation will be a “huge train wreck.”

Baucus is the first top Democratic senator to publically voice
such bold concerns regarding implementation of health reform. Many
consumers, he told the committee, will not have enough information
available to them to make informed healthcare decisions. Small
businesses are going to struggle if the administration doesn’t provide
them with more information and more assistance in the near-term future.
Baucus also spoke to the confusing nature of the law and the influx of
rules and regulations that have been quickly been coming down from the

Specifically, Baucus expressed his concern over navigators,
stating that whenever he has asked the Administration a question about
this program, he has received no answer. He went on to wonder out loud
if a top Democratic United States senator is having difficulty getting
answers from the Administration, how are businesses and consumers going
to get that information? Sebelius informed the committee that, come
summer, there will be many people on the ground in every state educating
the American people on the law and what to expect in the months to
come. Additionally, she promised that HHS will be holding webinars to
educate people on the role of navigators and how they may be of help
during this process. However, when Senator Baucus asked for concrete
data on the people in each state who will be going around educating
people, the secretary had no answer. Baucus, who seemingly became
progressively more frustrated as the secretary spoke, noted, “We need
data…you never give me any data. You give me concepts, frankly.”

Since making this statement, Baucus, who is up for reelection
next year, has received heat from both sides of the aisle. Some of his
fellow Democrats noted that they, unlike Chairman Baucus, were pleased
with the law and members of the Tea Party have deemed him a hypocrite.
Meanwhile, some Senate Republicans have welcomed him into the
“anti-ObamaCare” club despite his questionable timing. Following the
hearing, Baucus had an aide release the following statement: “There
should be no confusion about this. As Senator Baucus said yesterday, he
thinks this is a good law and he’s simply holding the Administration’s
feet to the fire to make sure they do their job implementing it
correctly and informing people about the benefits that are available to
them, which will bolster the efforts of folks working to implement it at
the state level.”

Meanwhile, after the hearing, Secretary Sebelius told reporters
that the exchanges are on track to open for open enrollment in October
and the marketplaces will be fully implemented come January 2014.

HHS is requesting from Congress an additional $554 million to
be used for outreach and education related to implementation of PPACA.
While HHS may have a concrete use in mind for the money, it is highly
unlikely that a Republican-controlled House will approve the additional
funding. Recent surveys have indicated that the majority of the American
public do not have enough information and do not have a true
understanding of how the health reform law will impact them. There is a
clear need for more education and outreach of PPACA. The trillion-dollar
question, however, is still: How is this actually going to happen?