The umpteenth Obamacare fix

For the umpteenth time, the Obama administration has made a mid-course correction to the implementation of the new healthcare law. This time, the administration on Monday gave consumers in 34 states one additional day — Tuesday — to buy coverage that will go into effect Jan. 1. The seemingly never-ending series of delays, exemptions and extensions have added to the confusion surrounding the requirements imposed by the Patient Protection and Affordable Care Act, better known as Obamacare. That’s not helpful. But it would be worse to do nothing in the face of the problems that have surfaced in the course of a very difficult transition to a better system.

The latest delay was aimed at helping those caught up in the last-minute rush to sign up through the federally managed exchanges or the website they share, HealthCare.gov. That crush stemmed in part from the disastrous technical problems that rendered the website all but useless for the first month after it opened for enrollment. The change came just days after the administration announced that it was summarily waiving for one year the mandate to buy insurance for anyone whose policy had been canceled. Before that, the rules had been altered at least six other times.

Some critics of Obamacare argue that the spate of changes show that Washington’s reach exceeded its grasp. A simpler explanation is that the uncertain progress shows how hard it is to make the systemic changes needed to fix the healthcare system’s complex and intertwined problems. The ambition of the Affordable Care Act wasn’t motivated by hubris, it was necessitated by the challenge posed by the system’s perverse incentives, its runaway costs and the growing number of uninsured people.

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The administration certainly handled several key tasks poorly, and Democrats grossly underestimated how much harder it would be to implement the law if states opted out, as most of those with GOP legislatures have. President Obama made matters worse by repeatedly promising people that they could keep their current policies, despite new coverage standards that were designed to eliminate many of those plans.

Still, you can’t turn the market for individual coverage, which insurers designed to minimize their risks, into something that functions more like the market for large group plans, where risks and costs are broadly shared, without wrenching changes. And the bumps will continue through the next year or more as the transformation ripples through employer-provided plans and the law’s cost-control efforts gain momentum. As much as we wish the administration had managed the transition better, we don’t fault its efforts to adapt on the fly. We only wish Congress was more engaged in making the law work rather than battling endlessly over whether to make it go away.