My colleague Chad Terhune in The Times' Business section has been faithfully cataloging the hiccups, glitches and failures experienced by the state's new health insurance exchange, Covered California, in its opening days. On Friday he laid out the most serious of the shortcomings reported so far: The health plans don't yet provide an online list of the doctors and hospitals participating in their networks.
This is a crucial issue, as faithful Terhune readers know, because some insurers are including fewer doctors and hospitals in their Covered California offerings in order to cut costs. And because it's the exchange's first year, there are no quality ratings yet to tell how such "narrow" networks perform.
Peter V. Lee, the exchange's executive director, had warned that insurers might not be ready on Day 1 to list their provider networks. That information is expected soon, possibly on Monday. And with the coverage not taking effect until January, a brief delay in the provider lists isn't a big deal -- people aren't likely to commit to a plan (and get billed for it) until we're much closer to the end of the year.
Nevertheless, you can't expect people to sign up for a plan without knowing whether it includes the doctors who have been treating their families, assuming they want to keep those doctors. Even those who've been uninsured and getting treatment in emergency rooms will want to see the list of providers, if for no reason other than to find one near their home.
With any venture on this scale, there are bound to be unexpected bumps in the road. But critics of the Patient Protection and Affordable Care Act, better known as Obamacare, say that the problems documented by Terhune and his counterparts around the country show that the exchanges simply weren't ready for the roll out -- and providing all the more reason for Congress to delay implementation of the law.
Of course, some other critics (including a growing number of those who comment on this blog) argue that the exchanges are bound to fail regardless because of the ACA's complexity and the likelihood of adverse risk selection (that is, healthy people not signing up for coverage, causing premiums to skyrocket as insurers are stuck covering only ailing, costly customers).
But what about you? Is it better for Covered California to push ahead and learn by doing, or should the exchanges have waited until they got all of their ducks in a more orderly row? Take our statistically insignificant poll, leave a comment or do both!