I have been dismayed, but unsurprised, to see that the Department of Health and Human Services (HHS) is already spinning the launch of its federal health insurance exchange this October. The federal and state “exchanges”​—​HHS recently rebranded them “marketplaces”​—​are a linchpin of the Affordable Care Act (ACA) that would allow uninsured Americans to assess and select health insurance plans. Repeated HHS assurances that the systems will be ready for launch have been a critical factor in state decisions as to whether they should use the HHS portal or build their own; at least 14 states have wisely chosen to build their own systems.

A functional and legally compliant federal exchange almost certainly will not be ready on October 1 for those who will have no choice but to use the federal portal. The reasons for failure are not short timelines (Congress gave HHS more than three years), political interference (Congress has not focused on ACA systems), or complexity (states have built well-designed exchanges). The reason is plain old incompetence and arrogance.

After enactment of the ACA, the former administrator of the Centers for Medicare and Medicaid Services (CMS), Donald Berwick, had the responsibility of creating systems for the exchanges, which required peripheral support from the Social Security Administration (SSA) and the Internal Revenue Service (IRS). Congress did not appropriate special funding for this initiative,

http://www.weeklystandard.com/articles/privacy-be-damned_741033.html