A health insurance exchange is more than a Web site. It is an insurance store, and to manage it well requires insurance experience, technical know-how, and savvy marketing and sales tactics. The administration has a few months to put together a management team with these skills, dedicated exclusively to running the world’s largest store for private insurance. The Centers for Medicare and Medicaid Services have talented staff, and Jeffrey Zients, a former budget official who’s been called up to help fix the federal exchange’s online enrollment, may be just the guy to corral wayward technology vendors. But selling insurance is not what policy analysts and turnaround specialists do. I had 45 employees dedicated to operating the Massachusetts Health Connector; California has budgeted more than 300. Who’s minding the federal store?
If the administration fails to convince hundreds of insurers that the federal exchange will do a superb job marketing their products next fall, what then?
Premiums will jump, Democrats will blame “greedy” insurers, regulators will review rates and push for price controls. And Republicans can credibly crow: “We told you so.”
If you are someone who wants to understand the scope of the challenges involved in making the federal exchange work—a really great read!
If you are a Democrat feeling vulnerable about the prospects of the Obama Administration putting the pieces together before November, 2014—not so much.