It's Too Late to Delay Obamacare

The website is riddled with glitches—why not just postpone the launch? Because doing so could increase customer costs or deprive citizens of coverage entirely.
Jason Reed/Reuters

Delay is in the air.

Marco Rubio on Monday introduced the “Delay Until Fully Functional Act” to postpone the Affordable Care Act's individual mandate until six months after the government could certify "that the exchange website is fully functional." Ten Democratic senators have now signed on to a letter, drafted by New Hampshire Senator Jeanne Shaheen, asking the president to extend the open-enrollment period beyond March 31. West Virginia Democratic Joe Manchin called for a "transition period" in Obamacare and some mechanism to prevent costs to people already in the individual market from going up. "Nobody should be forced to buy a policy that costs more than what they had and is inferior to what they had," Manchin said Sunday on ABC News's This Week. An individual-mandate-delay bill already passed in the House in July 2013, with 22 Democrats joining Republicans to vote for it, and then again right before the government shutdown in September. Several Republicans have called for a halt in the whole system while is fixed. "Congress should press 'pause' on the tech surge and figure out what went wrong first before throwing good money after bad and forcing the public to use a broken site," said Pennsylvania Rep. Tim Murphy at a hearing in October.

But it is too late to delay Obamacare. The private health-insurance market is in the throes of major changes, and there is no going back. Anyone who is calling for the system to be put on pause at this point is calling for the millions of people being moved out of existing private-market plans to have fewer options for new coverage, instead of more, and for them to be denied opportunities to find subsidies for plans. And anyone calling for a significant delay in imposing the individual mandate is putting at risk the affordability of the entire private individual-insurance market as it's been shaped to meet the law's requirements over the last three years, insurers warn.

“The individual mandate is inextricably linked to the insurance-market reforms included in the health-care-reform law," said Robert Zirkelbach, a spokesman for the industry group America's Health Insurance Plans. There are historical precedents for trying to overhaul the insurance system without mandates in the states, and those precedents are failure.

"In the 1990s, several states enacted insurance-market reforms without achieving broad participation and it failed," Zirkelbach said. "Premiums increased dramatically, consumers and employers had fewer coverage choices, and the number of uninsured increased." To avoid "repeating the state experience," the 2010 health-insurance overhaul mandated that everyone purchase coverage and established a long initial open-enrollment period "to incentivize young, healthy people to purchase and maintain health insurance rather than waiting until after they get sick or injured to sign up." Without these young people purchasing insurance in the markets, the whole pricing structure of the private health plans in the new markets goes haywire.

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Garance Franke-Ruta is a former senior editor covering national politics at The Atlantic.

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