WASHINGTON — President Barack Obama's health care overhaul is unfolding as a national experiment with American consumers as the guinea pigs: Who will do a better job getting uninsured people covered, the states or the feds?
The nation is about evenly split between states that decided by Friday's deadline they want a say in running new insurance markets and states that are defaulting to federal control because they don't want to participate in “Obamacare.” That choice was left to state governments under the law: Establish the market or Washington will.
With some exceptions, states led by Democrats opted to set up their own markets, called exchanges, and Republican-led states declined.
Only months from the official launch, exchanges are supposed to make the mind-boggling task of buying health insurance more like shopping on Amazon.com or Travelocity. Millions of people who don't have employer coverage will flock to the new markets. Middle-class consumers will be able to buy private insurance, with government help to pay the premiums in most cases. Low-income people will be steered to safety net programs like Medicaid.
“It's an experiment between the feds and the states, and among the states themselves,” said Robert Krughoff, president of Consumers' Checkbook, a nonprofit ratings group.
Krughoff is skeptical that either the feds or the states have solved the technological challenge of making the purchase of health insurance as easy as selecting a travel-and-hotel package.