The Obama administration has repeatedly insisted that efforts to launch Obamacare are on track and on schedule. Recent delays of the law's employer mandate, reporting rules, income and health status verifcation requirements, small-business choice provisions, and out of pocket caps for consumers suggest that not everything is going on schedule. But it's hard to know what's really going on inside the implementation effort. Do these delays represent systemic problems with implementation? Or are they isolated issues?
Even well-connected health consulants and reporters appear to be largely in the dark. As Deloitte health care consultant Cheryl Smith said in a July report by The Washington Post's Ezra Klein and Sarah Kliff, "It's pretty much a black box. [The administration tells] us, 'It's freakishly on schedule.' They use those exact words. But only the people who work in this can tell you if it's actually running on time."
A newly public June report by the Congressional Research Service indicates that the implementation effort has consistently struggled to meet deadlines. As of Forbes' Avik Roy, who first obtained the memo, reports, and as Nick Gillespie noted yesterday, the administration apparently missed fully half of the 82 deadlines reviewed for the report. And, as Roy further notes, that's being generous. Ignore the nine deadlines Congress didn't appropriate funds to meet, and the administration missed 41 out of 73 deadlines, a 56 percent miss rate. Granted, the majority of these missed deadlines aren't for integral parts of the law. As Roy says, "the document reads like a kind of caricature of bureaucratic busywork," with a number of deadlines for trivial reports and determinations.
This doesn't mean that the health law implementation effort won't cross the finish line on October 1, when the exchanges are set to open. But it does mean there's a history of behind-schedule work. And it's further confirmation that federal analysts who aren't actively involved in the implementation effort themselves won't support the administration's public declarations that all is going on schedule. A June report on exchange implementation process by the Government Accountability Office also found missed deadlines. And the only conclusion that report offered was uncertainty. "While the missed interim deadlines may not affect implementation," it said, "additional missed deadlines closer to the start of enrollment could do so."