Obamacare faces significant hurdles in implementation. Healthcare is complex, and made much more complex by state and federal regulations. It is administered using massive computer systems, some of them decades old. These systems are difficult to change and modify, yet they will all require modifications to comply with the raft of new regulations introduced by Obamacare. Private organizations face the added burden of making these changes while complying with SOX [Sarbanes–Oxley Act of 2002] procedures. It is no exaggeration to say that SOX doubles development time and doubles the staff needed to do development. SOX makes it very difficult to use modern rapid development methodologies and forces organizations to use older methodologies that are long on paperwork and short on results. . . .
Quoting from Politico:
If state health care exchanges survive the Supreme Court challenge to health care reform, the election and state tea party activists, health policy experts are worried they could still be brought down by a much more mundane problem: information technology.Even states that are solidly committed to pursuing an exchange are facing major logistical challenges in building the computer systems that will be able to handle enrollment when exchanges open for business in 2014.That’s largely because the system that will actually connect people to the right coverage will have to “talk” to many other systems, and the systems don’t use a common language. This includes a yet-to-be built federal “data hub” with tax and citizenship info, the enrollment systems of multiple private insurers selling exchange plans and — hardest of all — state Medicaid enrollment systems, many of which are not yet fully computerized.
[back to Standing Pat]: Anyone who has observed the Government’s sorry record on implementing complex IT systems on time and within budget just know that this is a disaster waiting to happen.
The Health and Human Services Department "was given a billion dollars implementation money," Republican Rep. Denny Rehberg of Montana said. "That money is gone already on additional bureaucrats and IT programs, computerization for the implementation."
"Oh boy," Stan Dorn of the Urban Institute said. "HHS has a huge amount of work to do and the states do, too. There will be new health insurance marketplaces in every state in the country, places you can go online, compare health plans."
The IRS, Health and Human Services and many other agencies will now write thousands of pages of regulations -- an effort well under way:
"There's already 13,000 pages of regulations, and they're not even done yet," Rehberg said.