Either the U.S. Department of Health and Human Services (HHS) Patient Protection and Affordable Care Act (PPACA) exchange enrollment systems will work, or they won’t.
Either the PPACA public exchange plans will start up in 2014, or they won’t, and, either the PPACA health insurance product rules — especially the individual and small group rules — will take effect in 2014, or they won’t.
It seems hard to tell. I used to try to include disclaimers in my stories along the lines of “if PPACA takes effect as scheduled in 2014 and works roughly as backers expect.”
My editors got sick of reading the disclaimer and made me stop putting it in. Maybe I need to negotiate to get it back into their good graces…
But, anyhow, my guess is that either enrollment will end up going OK, and the next big story to cover will be problems with the “three R’s” — the reinsurance, risk corridor and risk adjustment programs PPACA drafters included in PPACA to try to keep all of the PPACA changes from wiping out nice, warm-looking health insurers that somehow ended up covering all of the really sick people.
If PPACA collapses and blows away, the story will be about the absence of the expected PPACA changes somehow causes risk management problems roughly comparable to what PPACA itself would have created.
The coming year will be a year in which actuaries at Milliman, S&P and Moody’s probably have a shot at getting booked on The Colbert Report. Maybe The Daily Show. Maybe the 2014-2015 television season will be the first television season ever during which a health insurance actuary gets onto Saturday Night Live.