CMS and You

Here’s my take on this interesting article from Avik Roy over at Forbes this morning, about progress toward implementation of Health Care Exchanges.

Gary Cohen, a CMS official involved in exchange implementation, said “my hopes are the range of things that could go wrong gets narrower.”

Henry Chao, an official at CMS, said he once held high hopes that the exchanges would run smoothly from the beginning, but “those hopes had been dashed”.

Hope?  Well, I hope that CMS and you have been clinging to more than “hope”.   I hope it, but I’m beginning to doubt it because so little hard evidence is emerging to suggest CMS and you will succeed.

Avik Roy mentions rate shock in his Forbes article.  I think CMS and you know that you face more immediate problems:

Let’s start with the fact that your CMS is even less able than the states to set up and run Exchanges in the 192 days remaining between March 22 and October 1 when Exchanges must be prepared to process January 1 enrollments.  It’s an open question whether CMS and you have the resources or the time.  You know full well that 26 states elected not to set up their own Exchange – meaning the implementation falls heavily on CMS and you, in each of those states.   From what you say now, it appears that CMS and you will have to step in and help still more states, ones that first said they could do the job, but now find they can’t.  

A second more immediate problem for CMS and you is more personal – what do you suppose the Fair Kathleen Sebelius said last week at the closed-door meeting of the Senate Finance Committee session on ObamaCare implementation? Do you think she is preparing to accept responsibility for any implementation failures?  Or do you think she is setting up CMS and you to take the fall for any tactical failure to execute the misguided health policy that she stoutly defended for 4 years?

 A third more immediate problem for CMS and you is revealed in the statement “Let’s just make sure it’s not a third-world experience.”

Yeah?  You mean CMS and you intend to work against the President’s wishes?  Good luck with that, Henry, Gary, and CMS.  Good luck with that, America.