Some LifeHealthPro.com readers love every aspect of Patient Protection and Affordable Care Act (PPACA).
Some hate every aspect of the law, down to provisions that are even more obscure than the tanning salon tax and less closely associated with health care. Maybe some of you are burning with fury about the PPACA emerging infections prevent grant program funding.
I suspect that many are in the middle, and that some are roughly in sync with me: We just want whatever makes everybody else happy and, ideally, works as well as it can work, under the circumstances.
The whole idea of “Get PPACA-related rules, programs and agencies to work as poorly as possible, to make Democrats look bad” seems like bad policy to me, and especially unhelpful from the perspective of people who hate PPACA on principle.
In my opinion, if you truly hate the PPACA exchange system, you should favor giving it enough funding and flexibility to show that it was doomed to fail even under the most favorable circumstances. You shouldn’t want exchange lovers to have any reasonable ability to make the argument that the exchange system failed because the haters strangled it.
Given all that, I think that, if Congress ever reaches a state such that it can sincerely try to improve the exchange system, one priority should be getting it out from under the Centers for Medicare & Medicaid Services (CMS), and out from under the parent of CMS, the U.S. Department of Health and Human Services (HHS).
On the one hand, CMS has gotten a huge new program running quickly, and, in spite of the various glitches and disappointments, there’s no clear-cut evidence that HealthCare.gov or the state-based exchanges have had any more problems than the typical private exchange program creator.