Despite almost fours years of preparation many significant provisions in the Affordable Care Act will not be ready for 2014. The Obama administration’s decision to delay the employer mandate until 2015 now makes it the third major coverage expansion provision that will not go into effect on time.

Earlier this year the administration announced the employer selection aspect of the SHOP exchange would not be ready in states where the federal government is running the exchanges. It was meant to give employees of small companies the same flexibility to select their own plans as federal employees. Earlier on it was a major selling point for the law.

In addition, the Basic Health Plan was also delayed until 2015. It would have allowed states to create a public program to cover everyone making between 133-200 percent of the federal poverty level without insurance. More than likely, it would have provided people between 133-200 percent of FPL better coverage at a lower price than they will receive on the new exchanges.

I think it is worth pointing out that if we simply created a program that just gave the uninsured basic public insurance, similar to single-payer, the program could have been easily implemented in a matter of months. Instead we went with a Rube Goldberg law that even after four years of implementation is still going to require several significant delays.

Photo by hitthatswtich released under Creative Commons License