The Washington Post breaks down the problems that broke down HealthCare.gov, the online marketplace for health insurance for individuals and small businesses, in states that chose not to form their own such exchanges.
“They were running the biggest start-up in the world, and they didn’t have anyone who had run a start-up, or even run a business,” said David Cutler, a Harvard professor and health adviser to Obama’s 2008 campaign …“It’s very hard to think of a situation where the people best at getting legislation passed are best at implementing it. They are a different set of skills.”…. the project was hampered by the White House’s political sensitivity to Republican hatred of the law—sensitivity so intense that the president’s aides ordered that some work be slowed down or remain secret for fear of feeding the opposition. Inside the Department of Health and Human Services’ Centers for Medicare and Medicaid, the main agency responsible for the exchanges, there was no single administrator whose full-time job was to manage the project. Republicans also made clear they would block funding, while some outside IT companies that were hired to build the Web site, HealthCare.gov, performed poorly.”
“HealthCare.gov: How political fear was pitted against technical needs” (WashingtonPost.com)