But there were two tidbits in the 2,800-word piece that were previously known but still served to enrage me, especially now that we see how well the GOP’s premeditated campaign to try to kill
Healthcare.gov is working.
Although the statute provided plenty of money to help states build their own insurance exchanges, it included no money for the development of a federal exchange — and Republicans would block any funding attempts. According to one former administration official, [Health and Human Services Secretary Kathleen] Sebelius simply could not scrounge together enough money to keep a group of people developing the exchanges working directly under her.
So, the federal exchange that Republicans said wouldn’t work ended up not working because it was starved of the money needed to help make it work.
A larger number of states than expected were signaling that, under Republican pressure, they would refuse to build their own online insurance marketplaces and would rely on the federal one. The more states in the federal exchange, the more complex the task of building it. Yet, according to several former officials, White House staff would not let this fact be included in the specifications. Their concern, one former official said, was that Republicans would seize on it as evidence of a feared federal takeover of the health-care system.
So, the federal exchange that Republicans said wouldn’t work ended up not working because the GOP pressured Republican governors to not form their own state exchanges. This made the federal task more complex and difficult, thus ensuring its failure.