With the Oct. 1 rollout of government-operated health insurance purchasing exchanges, Obamacare will reach its most important milestone yet. After years of claims and counterclaims, repeated House votes to repeal the law, even an attack ad with Uncle Sam as a leering would-be gynecologist, we’re about to see how this experiment in almost-universal health insurance will work. That is, unless congressional Republicans manage to defund a law that loquacious Senator Ted Cruz of Texas calls a “glitch-riddled health-care takeover that is killing jobs, wages, and health-care benefits all across the nation.”
Glitches and all, Obamacare can work if given a chance. But it’s more complicated than your average piece of historic social legislation. That’s in part because the Affordable Care Act has set off a cascade of other changes in the U.S. health insurance industry. “What the ACA has done is put all 300 million-plus Americans in the mode of thinking about health care,” says Jim Winkler, a chief innovation officer at Aon, a London-based company that operates a private insurance exchange in the U.S.