The painful path to Obamacare deadline
U.S. President Barack Obama pauses during his his year-end news conference in the White House briefing room in Washington, December 20, 2013. REUTERS/Jonathan Ernst
By John Whitesides
WASHINGTON (Reuters) - Tuesday is a moment of truth for Obamacare.
It marks the final deadline for most Americans to sign up for health insurance under President Barack Obama's 2010 Affordable Care Act, popularly known as Obamacare, if they want coverage starting on January 1.
If enough people - and the right mix of young and old - do not enroll, the ambitious program designed to provide health benefits to millions of uninsured and under-insured Americans risks eventually unraveling.
The deadline caps a turbulent roll-out this year for Obamacare and the HealthCare.gov website that is key to enrolling millions of people in the initiative. The website crashed upon its launch on October 1, frustrating users trying to shop for insurance plans. It now is functioning much better, but is still not at 100 percent.
Despite the continuing problems, the administration is expressing confidence that Obamacare is getting back on track after enrollment accelerated in December, with more than 1 million people signing up for private insurance.
Here is a look at some notable moments in the months leading up to Obamacare's troubled launch.
EYES WIDE SHUT
In June 2012, Margaret Tavenner was worried.
As acting director of the Centers for Medicare and Medicaid Services (CMS), she was responsible for orchestrating the launch of the most sweeping U.S. domestic legislation in more than four decades.
With uncertainty surrounding how the new law would work, most states were undecided whether to establish their own insurance marketplaces or rely instead on a federally run exchange.
"What keeps me up at night is knowing around December, there are going to be like 30 states who want to come in and be state-based exchanges," Tavenner told a Washington healthcare conference, according to the Modern Healthcare newsletter.
Tavenner's anxiety - more than a year ahead of the planned launch of the exchanges - spurred concerns among industry and advocacy groups, which publicly questioned whether the multiple government agencies involved in the effort would be able to pull it off.
The White House was closely briefed on the issues. Tavenner was cleared to visit White House officials involved in the project 425 times from December 2009 to June 2013, including several meetings with Obama, visitor logs show. The White House said later that Obama knew only the broad picture, not details of the effort.
The administration also sought industry feedback, but some groups complained their warnings fell on deaf ears.
On a video of a February 2013 conference of health insurance brokers and agents in Washington, attendees could be heard grumbling when CMS official Chiquita Brooks-Lasure asked for feedback by the next day on a "streamlined" insurance application form.
The 21-page packet was jammed with questions on income and insurance status. For insurance brokers who had learned to keep it simple for customers, it was a harbinger of trouble.
"It was ridiculous," said Tom Harte, president of the National Association of Health Underwriters, which sponsored the conference. He said the group had been making suggestions to the administration on Obamacare enrollment for months.
"The image I always had (of the administration's efforts) was of a horse with blinders on, just plowing ahead and ignoring everything else," he said.