A Marketplace Odyssey: Countdown to October 1 (0 days)

Part of an ACHP blog series tracking health policy updates in anticipation of the start of the Affordable Care Act’s open enrollment on October 1.

Oct. 1, 2013 looked a lot different than anticipated after months of tight deadlines, a skeptical and confused public, and as of Monday at midnight, the first government shutdown in 17 years. But yesterday still marked the start of enrollment in state and federal health insurance exchanges.

People began logging on to the insurance marketplaces in pursuit of health care immediately upon their opening – over 2.8 million accessed healthcare.gov between midnight and late afternoon, according to federal officials. While some Americans are now registered for coverage for the first time in their lives, news outlets across the country focused on the many consumers who found computer glitches and web page errors. The White House remains unconcerned. Obama referenced the latest iPhone update to dismiss the criticism:

“A couple of weeks ago, Apple rolled out a new mobile operating system, and within days, they found a glitch, so they fixed it. I don’t remember anybody suggesting Apple should stop selling iPhones or iPads or threatening to shut down the company if they didn’t. That’s not how we do things in America.”

The Health Affairs Blog warns against the “misplaced hysteria” surrounding yesterday’s launch date. It is a start date, not a statutory deadline. Most experts agree that no complete judgment can be made until 2016, when the Department of Health and Human Services expects the law to reach a permanent level of uninsured Americans. Benefits kick in on Jan. 1, and the first leg of enrollment continues through March.

For now, most Affordable Care Act coverage is glued to the shutdown. This New York Times illustration explains the series of back-and-forth legislation that led to the impasse. Many of Brad Plummer’s  nine most painful impacts of a government shutdown are health-related. Among them, the Centers for Disease Control and Prevention must put its flu vaccine programs on pause, the Food and Drug Administration must halt some food safety procedures and the Department of Agriculture may start slowing its nutritional supplements for women and children. Wired Magazine’s Maryn Mckenna argues the shutdown could harm global health by ceasing data collection as flu viruses and other diseases pick up around the world.

“This is life-or-death stuff,” Obama said in his lunch hour address yesterday, urging senior Republicans to lead their rank-and-file members toward a spending agreement. While predictions initially limited a shutdown to a day or two, some are now expecting a week or more without PandaCam, parks and paychecks. For continuous updates check out these live blogs:


-Sophie Schwadron
ACHP Intern

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