Team Obama start to implement Obamacare

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The Obama administration is ramping up its plans to implement the so-called Obamacare health care law, with speeches from the president, new aides tasked with selling the law to the public and a broad push to get people to enroll for health insurance all coming in the next several months.

To lay the groundwork for the broader public, top administration officials are holding briefings with key members of the press and stakeholders. Secretary of Health and Human Services Secretary Kathleen Sebelius and White House Senior Adviser Valerie Jarrett recently met with more than 100 African-American leaders from across the country to talk about the law. President Obama is increasingly mentioning Obamacare in his speeches.

The White House has hired a special communications adviser, veteran Democratic strategist Tara McGuinness, to help rebut criticism of the law from both Republicans and increasingly some Democrats and improve public opinion about the Affordable Care Act.

Officials at HHS are in the process of hiring “navigators,” companies in states which will be specially contracted with the government to explain the health care law and urge people to enroll its programs. And starting this fall, an organization created by allies of the Obama administration called “Enroll America” will launch an aggressive, nationwide campaign, borrowing some of the tactics of the Obama campaigns in 2008 and 2012, to get people who are eligible to sign up for health insurance.

This work is in anticipation of Oct. 1, when Americans will formally be able to sign up under the so-called health care exchanges or the expanded Medicaid programs under the law. The Congressional Budget Office has estimated that as many as 7 million Americans will purchase insurance through these exchanges  for 2014 and 8 million will gain insurance through Medicaid, which has been expanded to cover nearly all adults who make below $16,000 a year (and around $32,000 for a family of four.)

But expanding insurance to 15 million additional Americans is hardly a simple task. Each state is supposed to create is own exchange, ideally some kind of online portal in which people could easily comparison shop for insurance plans and purchase one.  Some states have ceded this task to the federal government, but it’s unclear if the states that have said they will create exchanges have built the infrastructure for this to be ready by October.

So far, most Republican governors have balked at expanding their Medicaid programs, which could vastly reduce the number of people who benefit from the law, although the Obama administration is negotiating with many states to get them to accept the new federal funds for Medicaid.

And it remains unclear if enough young, health people will enroll to keep costs down.  Having healthier people in the insurance pool will help lower the average cost of insurance in the exchanges, because insurance companies will charge higher rates for coverage if they determine only older or already-ill people are signing up. (Under the law, insurance companies can’t charge higher prices based on your health status).

In addition, the administration is fighting against against a number of public critics of the law, who could undermine its support, even from people who stand to benefit from Obamacare. Republican governors in states around the country are sharply attacking the law, as are some insurance companies and Democrats who represent more conservative-leaning areas.

“The politics of this are difficult,” Sebelius said in a recent speech.