One of the conceits behind the sputtering conservative drive to make a Final Apocalyptic Stand against ObamaCare in the appropriations process is that the new law becomes effective on October 1, the day the new private insurance purchasing exchanges begin enrolling participants. But in fact, some provisions of the Affordable Care Act–notably the excess-profits insurance policy rebates, the provision allowing parents to keep adult children on their policies as dependents, and a ban on pre-existing condition exclusions for those under 19–have been in effect for a while. And as Wonkblog‘s Sarah Kliff points out today, the key provisions relating to the exchanges don’t really kick in until January 1, 2014:
[T]big day isn’t necessarily Oct. 1. Instead, it’s Jan. 1, the day that the individual mandate takes effect and any plans purchased on the marketplace actually kick in.
The space between October and December is viewed, by many standing up the health care law, as as soft launch: the time to make their new Web sites live, sort out the kinks and get the site in prime condition for the beginning of 2014.
The Medicaid expansion that the states have been wrangling over for the last two-odd years also doesn’t take effect until 2014, either.
For ObamaCare-is-the-end-of-civilization-as-we-know-it advocates, this issue matters a great deal. Thinking of October 1 as the day Leviathan rears its ugly head from the vasty deep and engulfs America tends to concentrate attention on the appropriations process since October 1 marks the beginning of a new fiscal year and appropriations cycle. But a January 1 “launch” makes the key pressure point closer to the anticipated breaching of the debt limit.
I suspect this argument is being quietly made by advocates for the delay-linked-to-debt-limit strategy as opposed to the defunding-linked-to-government-shutdown gambit. They are equally implausible, and a debt default threat is considerably more dangerous. But it at least is in better accord with the annual implementation schedule of the health reform law.