The second deadline has come and gone for individual states to choose to set up state exchanges that are required by Obamacare or to choose not to, and only 15 states have decided to spend the money on setting up the exchanges and all that entails, so now the Obama administration has 10 months to set up those exchanges for 30-35 states. (A few more might choose to set up a hybrid exchange with the Government)
Aside from the difficulties in setting up the exchanges, the Obama administration has one glaringly obvious problem that lies ahead for them... money.
Back in late November 2012, The Hill explained: (Emphasis mine)
It's a situation no one anticipated when the Affordable Care Act was written. The law assumed states would create and operate their own exchanges, and set aside billions in grants for that purpose.
“There's no way around it — this is a big job,” said Sabrina Corlette, a health policy expert at Georgetown University.
Since different states have different insurance markets and different eligibility requirements for Medicaid, Obama’s Health and Human Services Department can’t simply take a system off the shelf as a one-size-fits-all fail-safe.
"You can't simply deploy one federal exchange across the board," said Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation.
"Each state is different — their eligibility systems are different, their insurance markets are different. [HHS is] going to have to build these exchanges to fit into the context of each state."
Every state must have an exchange by Jan. 1, 2014, meaning HHS doesn’t have a lot of time to do a massive amount of work. The department could quickly run through a $1 billion fund designated for implementing the exchanges.
As I said at the time "Obama can forget about asking the House of Representatives for additional appropriations to fund this mammoth nightmare, ain't gonna happen."
Obama and Democrats "assumed" the states would create and operate their own exchanges.
A hell of an assumption considering the majority of taxpayers in those states, opposed and still oppose Obamacare as a whole, yet they "assumed" that those very people would tolerate their taxpayer money to be used to pay for Obamacare exchanges?
NRO's The Corner explains why states are smart not to set up these exchanges:
State officials are very smart not to set up their own exchanges since any costs beyond what the Feds offer to help pay is on their taxpayers’ dimes. Moreover, since the Obama Administration has centralized control of setting minimum coverage standards–see the Free Birth Control Rule–the flexibility of states to regulate in this area is severely compromised. I mean, why take the potential blameExactly. Obama and Democrats passed it alone, they should own it alone.
ifwhen things go badly when you don’t have a free regulatory hand?
To top it off, now it is on them to figure out how to pay for it.