Even in a U.S. government shutdown, Obamacare exchanges could function

Sat Sep 21, 2013 3:09pm EDT
 
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By Sharon Begley and Lewis Krauskopf

NEW YORK, Sept 21 (Reuters) - U.S. State officials behind the launch of President Barack Obama's healthcare reform on Oct. 1 say they could weather a federal government shutdown, though the scenario would add new pressure to the political attacks and technical issues that have weighed on the program's introduction.

Several officials running new state-based insurance exchanges that are due to open for enrollment next month said they expected to have access to funds in the case of a shutdown, which if it happens, would also start on Oct. 1, the beginning of the the fiscal year.

But they were unsure of the consequences for the federal agencies they work with, in part because they have not been briefed by the Centers for Medicare & Medicaid Services (CMS), the agency taking the lead in implementing the reform law.

The exchanges are key to the success of "Obamacare," as they aim to help millions of uninsured Americans receive benefits by providing government subsidies to buy insurance.

Officials involved in building the online marketplaces have already warned of technical bumps and glitches in the first few weeks after they go live, contributing to a slow start to enrollment.

Independent experts believe that "the effects of a government shutdown on the implementation of the ACA (Affordable Care Act) are likely to be pretty small," said Paul Van de Water, a policy analyst at the Center on Budget and Policy Priorities, a Washington-based non-profit think tank.

The main reason, he said, is that the money flowing to the 16 states and the nation's capital that are running their own ACA exchange is what's called a "permanent appropriation," enshrined in the 2010 healthcare reform law. Because the funds are not subject to annual appropriations, they will continue to be available to states that need to pay employees and contractors and buy equipment and supplies.

What is even less clear is the ability of the U.S. Department of Health and Human Services to operate a federal data "hub" that underpins both the state-run exchanges and the 34 state exchanges that fall under the purview of the administration.   Continued...