Mark McClellan: Healthier Americans Signing Up for Obamacare Is Bigger Challenge than Glitches in Health Exchanges Rollout

Mark McClellan, senior fellow with the Engelberg Center for Health Care Reform and a former chief of the Centers for Medicare & Medicaid Services, where he supervised implementation of the Medicare Part D (prescription drug benefit) program, spoke on CNBC today about implementation glitches with the Affordable Care Act (aka “Obamacare”). A full transcript of his part of the discussion appears below. Full video is available on CNBC. 

The systems online are not working now for the federal program yet—that’s the one that most states are relying on—there’s some individual states that have their own programs up and running. This is familiar. These programs that the government undertakes have to start nationally. You can’t test them in pilot markets. You can’t do beta versions on small sample groups. The real challenge is, can you work through these problems quickly? And I think the administration still has some work ahead of them, but they do have time.

The host asked if McClellan expected the glitches to be ironed out and if they are, are there more structural challenges ahead?

There are still some challenges ahead. Right now what the administration I expect is doing is identifying where in each step in the web programs they are losing people, where data isn’t going through, where people are dropping off. And they’re focusing on fixing each of those problems.

But as you said, when you get through these first round of issues with the website, there are bigger issues behind it. Not only can people log in and actually enroll in a plan, but then does that information go to the plan correctly? Are the government subsidies calculated correctly? Can people use the coverage when they get there?

And when people can actually use the plans—I know lots of people who have been waiting for coverage are going to sign up for this program—but what the program really needs is some healthier Americans, people who might not want to just sign up for this right away, they need to conclude it’s a good deal as well. So all of that is still ahead.

Get more research on the Affordable Care Act and also visit the Engelberg Center.