So much time has been spent on whether or not the Obama administration can get the exchanges barely functioning by December it has completely overshadowed the much more important issue of will the law actual work.
Functioning simply means the basic components exist and can be used. The administration has still yet to clear that hurdle, but at least at some point they will have something that’s operational.
Actually working is different. It requires the system not just to exist but to provide the advantages the administration promised. Obama made some lofty promises about this system to justify adding yet another expensive and extremely complex layer of bureaucracy to the system. He claimed exchanges would drive down cost through competition and allow people to make the right insurance decision for themselves. So far there is really no reason to believe exchanges actually work at controlling cost.
Right now people can’t even see their exchange options so that is the dominant issue, but the important question is will they be able to make the right choice when they do. The real success of the law depends on regular people being able to figure out extremely complex insurance products and knowing what to choose.
Even after the administration eventually gets the exchanges functioning there is no reason to think they will actually work as promised.
Image by Chris Messina, used under Creative Commons license