The state's online registration for Covered California has been up for a couple of weeks, and reaction has been mixed.
Steve Julian: Business analyst, Mark Lacter, what's your take on how well Californians are getting into the Affordable Care Act?
Mark Lacter: It's hard to get a good read, Steve, because it's hard to measure the success of what is really a new marketplace. If you're basing it on the number of unique visitors coming to the Covered California website, well, then the program clearly has attracted lots of interest - they had almost a million visitors during the first week of eligibility. But, maybe a better measure would be the number of people whose applications actually have been received by the insurance companies that are going to handle the claims. If that's your measuring stick, then the numbers have been far smaller so far. Now, it's worth pointing out that California - and particularly L.A. County - have a higher percentage of households without insurance than other parts of the nation, and so you'd expect there to be lots of interest.
Julian: So the question, then, is how many folks turn into actual policyholders paying actual premiums each month.
Lacter: The truth is nobody knows, which is why state officials want to sign up as many people as possible in the early going when the program is getting so much attention. This is especially true for younger and healthier people who are needed to help offset the cost of caring for older and sicker people.
Julian: And, that's also why any computer glitch can be such a headache...
Lacter: That's right. Covered California did run into problems in the early going, but everybody agrees that things are going much better than the federal website, which is the default site used by folks in states that don't have their own program to oversee the health care laws. That federal site has been an utter disaster. So, by comparison, California is ahead of the game.
Julian: It's a work in progress, even here.
Lacter: Very much so. The California website still doesn't have a way for enrollees to find out which doctors and hospitals are included in each health plan. And, that's a big deal because insurance companies are limiting the options available as a way of keeping premiums low. So, it's possible that the doctor you had been using for your individual insurance plan will not be on the list of doctors that can be used for one of the cheaper plans. Of course, for someone who doesn't have any health coverage, none of that is likely to matter.
Julian: And then, there's the continued threat of a U.S. default...
Lacter: You know, Steve, this is like watching the beginning of a bad traffic accident in slow motion - and we're all pretty helpless to do anything about it. And, so are the financial markets, which are moving back and forth not based on what's going on with the economy or with any industry, but on the latest press conference out of Washington. One thing we do know is that if the nation does go into quote-unquote default - and we're not even sure what that might mean - but if Wall Street and somehow declares this a major crisis, it's going to be bad.
Julian: Who gets hit?
Lacter: It'll impact anyone who has a retirement account, any business wanting to borrow money, and potentially it's going to impact the budgeting of the state. You know, one of the things we were reminded of during the Great Recession was how reliant California has been on higher-income individuals who make a lot of their money through the stock market and other investments. So, when those folks do well - as they have been over the last year - the state coffers will do well. And when they don't, as was the case in 2008 and 2009, the state takes a huge hit because there's not enough tax dollars coming in. Gov. Brown and others have tried to lessen the reliance on those top tiers - so far without success.
Julian: And the state's budget situation is so much better than it was a year or two ago.
Lacter: That's the real pity. And, even if the House and Senate reach a temporary agreement on the debt ceiling, it's just a matter of weeks or months before another deadline crops up - and more uncertainty for the financial markets. I guess Chick Hearn would have called this nervous time.
Mark Lacter writes for Los Angeles Magazine and pens the business blog at LA Observed.com.