Blamability: Medium. This sounds like the culprit for a lot of the problems. But both of the above explanations don't get to the real reason for the problems. Rather: Why are there bugs this close to launch date? For that we have to go deeper.
Congress: When passing the law, Congress didn't understand the technicalities of what they proposed, argues McArdle. "The fundamental problem," she says, "is that the people who were describing this amazing system seemed to think that if something could be easily described in English, it must not be that hard to do." That might be true, but McArdle doesn't provide much data. Plus, a lot of exchanges are operating just fine, suggesting that even if it is a hard thing to do, it's not impossible.
A more compelling way to blame Congress, however, is for setting the October 1, 2013 date. As McArdle notes, three years is not very long to build 50 exchanges. That timeframe had its political value, "They didn’t want to risk letting Republicans get into office and screw with their historic law," she writes. But that just means less time to get things done. So, instead of testing for these glitches months ago, the testing phase is happening a week before launch.
Blamability: Medium-High. That was just so long ago and some of the people who passed the law aren't in office anymore. But, yeah, all along the tight deadline has been an issue for Health and Human Services, the government agency implementing the reform. "Much remains to be accomplished within a relatively short amount of time," said a Government Accountability Office report back in June. Throughout the process, the organization has had to delay testing. Of course, glitches are to be expected — that's what testing phases are for — but it looks particularly bad this close to launch.
Republicans: Republicans siphoned funds and institutional support, which delayed the process. McArdle says it herself:
Republicans who were enraged at the party-line vote and the procedural maneuvering repeated the smug brush-off they’d been given by the president: "Elections have consequences." They refused to help Democrats repair the gaping holes in the bill, or appropriate extra money for the rollout.
Blamability: Medium-High. That money argument only really applies to the federally-funded exchanges. As an incentive, the state run exchanges got unlimited funding to build their systems. Federal exchanges, however, had limited funds. So, on a federal level, if this is a money problem we can doubly blame the Republicans. Not only did they refuse to "appropriate extra money" but a majority of the federally-run exchanges are in Republican states, as you can see in the chart via Wonkblog at right.
The Federal Government: Or, more specifically, Health and Human Services, the bureaucracy in charge of implementing health care reform. Again, McArdle's they-don't-understand-tech-things argument works here.
Blamability: High. This organization works with all the separate actors above and therefore can be blamed for each and all problems.
This article is from the archive of our partner The Wire.