If you think it is bad now, it is going to get a lot worse. I am not a member of either party, despise both of them, and am sick of this false dichotomy framing of every god damned issue with Republican spin vs. Democratic spin.
Congress no longer reads the Acts they vote on that are written by lobbyists, let alone the voters, and the debates are usually misguided theoretical scuffles having little to do with what is actually in the law nobody is reading.
In this case the insurance company lobbyists wrote up what they thought would be a money printing machine for themselves. But they took a bad gamble here and it is going to be a train wreck of historical dimensions. What they banked on was government coercion of the young and healthy being successful. But both Obama and the democrats who pushed this bill through are already backing out of the very things the insurance companies needed for this to be successful.
I took most of my statistics courses during my PhD studies in an actuarial science department at the University of Iowa. What is going to happen is young people will correctly choose not to pay for insurance that makes no economic sense for them, and the profile of enrollees is going to be skewed to clients representing large payouts. That no-brainer has already proved out.
Since the insurance companies will not have the young healthy pool paying money into the system to cover the older, sicker people then the insurance companies will have to raise rates to reflect the actual costs of care plus the administrative costs and profit margin. It has been called the death spiral for that reason. The higher the rates go, the more people that drop out on the young end of the scale, making rates go even higher for those who stay in.
In the early years the insurance companies got three provisions into the law that guaranteed their losses, if any, would be subsidized by taxpayers. But the taxes required to fund that given the certainty of the death spiral are staggering and something that will require taxing everyone heavily or vastly more unsustainable borrowing by the government. They are supposed to be phased out so rates will have to be much higher when the taxpayers are not bailing them out.
The high rates millions of people are already facing are going to look like peanuts compared to the rates in the out-years, and that is why it was so important to delay 2014 enrollment until after the next election. Insurance companies will be re-setting their rates then based upon what is guaranteed to be a high risk pool of insured rather than what they thought congress and the president were going to secure for them by coercion.
Obama has already proven that he will do what is politically expedient at the moment like extending deadlines for the employer and now individual mandate. He thinks he can somehow bypass all the state insurance commissions and simply by fiat tell insurance companies to go along with whatever today's new political decision is. But setting insurance rates requires a stable law upon which actuarial rates can be determined and approval by the state commissions. It took months and months to both estimate rates based upon what they thought congress was delivering to them by coercion, design all of their computer and administrative systems to accommodate, and go through insurance commissions for approval. Obama has already proven either incredibly ignorant of how the insurance industry works or a liar.
Now it is utter chaos and the only thing that is for sure is the death spiral and cancellation of millions of policies that do not comply with Obamacare mandates. The individual market is nothing compared to what is going to happen when all of the employer based insurance policies are cancelled.
The back end of the Obamacare computer nightmare has not even STARTED. This is the part of the system that actually administers the system and gets money paid out to the insurance companies. In some respects this is more complicated than the front end of the system that they have screwed up so badly. The fact they have not even started yet on a system that is supposed to be in full operation shortly is just incredible.
With the front end not even working properly yet, the law in a state of constant flux, the back end not even started yet, millions of policies being cancelled, this is going to be an epic crisis. Partisan politics has to be set aside now because this nation is in serious trouble with something vitally important to everyone.
Whether Obama lied or is an ignorant fool about his own signature law is irrelevant. His promises of keeping your insurance when the whole point of the law was to replace everyone's insurance with much greater coverage than they wanted and the promise about keeping your doctor - those were false and his recent so-called administrative fixes guarantee the death spiral and yet more panic responses by Obama.
His claim that he was not "directly informed" of the nonfunctional website - same thing there. It is either a lie or monumental incompetence to not be actively managing the thing alleged to be your singular accomplishment. How does this bode for the future? The defenses offered insofar as this being a hugely complicated venture are also telling for how incapable the peddlers of this excuse are in seeing what it means for the future: Obama and the Democrats were delusional about how easy this was going to be but then turn that around on everyone else! As if the critics were the ones who were saying this was going to be easy! Well just look how the next promise about the website being ready at the end of this month so easily tripped off his lips. I guess in December he will be telling us that we again are the ones guilty of underestimating how enormous this problem was.
People who poo-poo it as "just a website" problem are delusional. This website is the means of running the god damned program. It's like pretending the wiring of the space shuttle is just decoration. As if it will fly just fine even with the wiring non-functional. Hoping that paper applications will save the day is delusional not just because it ultimately requires a functional computer system anyway, but because of the ignorance in how this stretches the period of time required to accomplish anything while simultaneously chirping about how it will all be better in a month. It is surreal.
When millions of individuals and employers face the sticker shock that is absolutely guaranteed to come there will be more political panic and more ill-conceived "fixes".
By looking at other industries we can predict some other kinds of things that will happen like medical clubs springing up to evade the system entirely or whatever. There will be early retirements by doctors who aren't going to want participating just like they have been dropping out of medicare. The insurance companies will not only be raising rates, but cutting payments to doctors, eliminating specialists or hospitals specializing in advanced treatments.
All of this is a consequence of a bad law, not a bad website. The problems in the website are absolutely a function of that bad law. Many at this forum eagerly support a national single-payer system and are misguided in applying that support to a law that isn't even remotely such a system.