JAMA Forum: The Affordable Care Act After Week 1: What We Know and What We Don’t Yet Know


It is now common knowledge that the new health insurance marketplaces (also known as “exchanges”) created under the Affordable Care Act (ACA) got off to a rocky start last week. Indeed, it’s possible that more Americans now know about the technical glitches experienced by the exchanges than even knew open enrollment was beginning October 1. In fact, just 1 in 8 of those who potentially have the most at stake—uninsured individuals—was aware of the October 1 debut of the exchanges, according to the Kaiser Family Foundation’s latest tracking poll.

Many observers anticipated early hiccups in the eligibility and enrollment systems (see, for example, my JAMA Forum post from February). Assuming these initial computer problems in the exchanges are fixed soon, none of this will ultimately matter to people, particularly people who were previously uninsured. The Medicare Part D drug benefit experienced similar technical challenges at first when it started…

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About ethicsbeyondcompliance

I hold a PhD in medical humanities with an major emphasis in ethics. I began teaching college-level ethics in 2000.
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