The administration's announcement on Friday that it was delaying the enrollment deadline to sign up for health insurance by eight days is at least the eighth announced delay in implementing the Affordable Care Act since the summer.
If you thought that the argument over delaying implementation of the final major phase of ACA broke down across partisan lines, with Republicans calling for delay and Democrats resisting, think again. The White House has long acknowledged that a law this complex would normally require a package of legislative fixes as implementation proceeded. But with House Republicans fixated on repealing the law, the administration saw no way to legislatively address problems that have arisen since the 2010 midterms without opening up the possibility of the entire project coming undone.
Most recently, Republicans pressed to delay the rollout of the final major phase of the law until after the 2014 midterm elections, in hopes that the GOP could retake the Senate and finally repeal the law before a wave of changes created facts on the ground. The administration fought off this bid for a delay and blocked GOP efforts to defund implementation of the law in toto, but not before the impasse had led to the government shutdown, which began October 1—the same day as open enrollment in the exchanges.
The shutdown was more the result of the administration trying to defend the very existence of the law and how it would remake the health-insurance environment than it was a sign of certainty that everything was on track. Already by the time of the shutdown, executive-branch officials had announced delays to significant parts of the ACA rollout.
Here are eight of the delays in parts of the ACA announced by the administration since the summer:
1. Enrollment-Deadline Delay: On November 22, the Department of Health and Human Services announced the deadline to enroll for January 1 coverage had been pushed back from December 15 to December 23.
Result: People who are currently insured but whose plans are being cancelled will have another full week to try to get coverage through the improved Healthcare.gov or other sites. That lowers the odds that that they will become uninsured en masse in January if there's not enough time to get new insurance through a functional exchange before their old plans lapse.
2. 2015 Open-Enrollment Delay: On November 21, the administration pushed back the start of open enrollment for 2015 from October 15 to November 15, 2014, avowedly for technical reasons though with some pretty handy political results, too.
Result: The delay guarantees there will be no new website snafus right before the November 4 midterm elections. Insurance rates for 2015 will still have to be set before the midterms so they can be approved by insurance commissioners, but the delay reduces the risk that regular people will encounter rate shocks and technical glitches right before they cast their ballots, as customers paw through websites looking at their 2015 options. As well, every year after this first one, insurers offering plans through the exchanges are supposed to have nine months between open-enrollment periods to sort out who's in their risk pools and what they want to offer the following year. This year they only had six months because of the unusually long initial open-enrollment period. Delaying 2015 open enrollment will give them seven months in the first year instead of nine. It would seem to open up some room to extend first-year open enrollment for a month beyond March 2014, too—something many red-state Democrats have requested.
3. Effective Tax-Penalty Delay: In late October, officials announced they were effectively delaying the imposition of the tax penalty for being uninsured. People who purchase insurance during the final month and a half of the open-enrollment period, which ends March 31, will no longer be at risk of having to pay a fee even though they followed the rules.