Would All State-Based Exchanges Have Been Just as Problematic?
While Heathcare.gov’s first two months were a disaster, the federal exchange’s performance was about average when compared to all states that tried to created their own.
I find this chart from Kevin Drum at Mother Jones comparing how well the exchanges have done at enrollment fascinating. (Red is state-based, blue is federal)
First, it proves the Obama administration really could have done a better job, like Vermont and Kentucky did. The early problems with Healthcare.gov were unacceptable administrative incompetence.
This graph also shows, though, that creating these complicated exchanges is really different. While Healthcare.gov was dreadful in October, it has still managed to perform much better than blue states like Maryland and Oregon who really tried to build state-based exchanges.
Despite all of Healthcare.gov problems its performance appears be right in the middle compared to the 13 states-based exchanges. Looking at this data, it is fair to assume that even if all the states actually tried to set up their own exchanges –like the law initially envisioned– the early roll out of the ACA probably won’t have gone much better or worse.
Except by having the federal government build most of the exchanges means the blame is being directed at Obama instead of local state officials, like Maryland Lt. Gov. Anthony G. Brown (D) who’s getting hit in the 2014 governor’s primary for the poor performance of his exchange. In retrospect, Republican governors made a smart political move leaving the complex task with Obama.