Let's fix it now
Given that the Affordable Care Act is meant to transform health care, and that it is the signature program of the Obama administration, it is remarkable that the debut of its key provision has been a mess.
Technical problems with the healthcare.gov website - the principal venue by which Americans may acquaint themselves with the law and sign up for coverage in 26 states, including Pennsylvania, that do not have their own insurance exchanges - can be corrected.
But if the glitches are not corrected soon, the technical problems could convert into economic issues affecting the viability of the law itself.
The key to the success of the ACA in expanding health insurance coverage, while diminishing costs within the health care system, is rooted in the very concept of insurance itself.
Insurance is designed to diminish risk by spreading it across a wide population. Drivers are required to have liability insurance, for example, even though most of them never have a claim.
That is the core of the ACA. The individual mandate, the key provision that was upheld by the Supreme Court, requires everyone to acquire some level of health insurance even though most of them never will need to cover catastrophic costs. The law creates several mechanisms to achieve that, but the system will not work unless young, generally healthy people pay into the system as a means of diminishing risk and covering costs for those more likely to need costly services.
Technical problems that have attended the rollout since Oct. 1 won't deter someone who needs coverage now from persisting and acquiring that coverage. But if the clunky system isn't up to speed soon, young, healthy, computer-savvy people aren't likely to be as patient.
The law provides penalties, through the tax code, for anyone who doesn't acquire insurance. But the government won't be able to penalize anyone who couldn't sign up through a faulty system. Unless the system is fixed soon, insurers could be left only with new enrollees with existing health issues rather than a broad, diverse population that generates revenue and diminishes risk. In that scenario, premiums would spike and more people would be left uninsured.
The administration must act decisively to prevent an inconvenience from becoming a disaster.