One of the great ironies of the impending government shutdown is that most Obamacare funding, the issue at the heart of the battle, won't be affected by the spending freeze. The funding for the Affordable Care Act is a permanent appropriation — meaning it was approved in a prior session of Congress (in 2010, when the act was passed) and doesn't have to be approved again. Republicans may argue that the Affordable Care Act isn't mandatory spending if no one's enrolled when the government shuts down, but during past shutdowns funding for entitlement programs has been safe. Funding for the techies fixing the all the glitches within the online exchange, however, isn't so set in stone.
According to Reuters earlier this month, the White House Office of Management and Budget said contractors can keep working through a shutdown, as long as the government agency they're working for has "already obligated funds representing the entire price under a contract." However, the Centers for Medicare & Medicaid Services, the government agency in charge of implementing Obamacare, declined to say whether that applied to Obamacare IT professionals.
Considering what a mess the exchanges are in, those tech people are pretty necessary right now. A New York Times piece on Sunday described the chaos in Oregon as contractors work to debug the online exchange, which has to send information between state, federal and insurance agencies.
At the state’s exchange here, known as Cover Oregon, posters urge the staff to “Keep Calm and Go Live.” Last week, 180 staff members and consultants were proofing some 500,000 lines of computer code, 1,500 Web site pages and 5,000 possible premium rates that will vary depending on where people live, how old they are, how much money they make and which insurance company and plan they choose. A downstairs conference room had taken on the look of a modern-day sweatshop, with long tables lined with workers tapping away on laptops. Even the bike storage room had been converted to a testing room.
We already knew that small businesses and residents of Washington D.C. won't be able to enroll on Tuesday due to technical hiccups. But, as explained in The Wall Street Journal on Sunday, the technical glitches are hampering the training of navigators, the people hired by the government to help people enroll.
Nonprofit groups and brokers that will help enroll consumers in the marketplaces, known as exchanges, say they haven't yet had a chance to preview the systems. Technical problems have limited certification for some nonprofit workers involved. And some of these groups say they haven't fully staffed up for the influx.
Between a buggy enrollment site and a shortage of navigators, some believe that individuals, especially the young uninsured, will rethink signing up due to early technical problems. Tom Scully, a Medicare director during the George W. Bush administration, told the Journal that "Every glitch is a human being" who could become frustrated. At the same time, insurance buyers have to start paying monthly premiums once they enroll, ahead of when their coverage starts on January 1. That being the case, the Obama administration predicts most people will enroll closer to late November, giving the exchanges more time to straighten out.
The less serious, but still detrimental, effect of the government shutdown will be the lack of exposure the Obamacare launch will receive in the media. "Less focus on Obamacare means fewer people hearing that the insurance marketplaces have gone live, and thus fewer people knowing they should go and sign up for coverage," The Washington Post argued on Monday.
And exposure is key, especially considering how many people still don't completely understand the Affordable Care Act. A Gallup poll conducted between September 17-26 and released today found that 31 percent of uninsured adults and 18-29 year olds did not know the Affordable Care Act mandates that everyone must be insured or pay a fine by January 2014. Fifty-one percent of uninsured adults said they were "not too familiar" with the health care exchanges. While the government plans on taking out paid advertisements to promote the enrollment period, stories on the launch — even stories on how buggy the system is — would have reminded people that Obamacare is live.