HHS said it will stand by the Jan. 1, 2014 operational start up for the exchanges. Weil puts little credence in speculation that HHS would delay the startup, even though by some estimates the federal government could save $23 billion with a one-year pushback.
"There is something like 15 states that are planning to do this and they would not be happy to be told ‘Thanks for the hard work, but put it on ice for a year,'" he says.
"The other thing is it is easy to talk about how much money you'd save, but remember this was a political compromise piece of legislation that included significant payment reductions to providers that they were willing to accept with the promise that their uncompensated care burden would go down as people gained coverage," Weil says.
'A little more time to get ready'
If you keep all of the cuts but don't do the coverage, sure, you can save some money. But you are also reneging on a deal that was designed to make it possible to afford this coverage. You really can't just look at one side of the ledger and say this will save money. It's more complicated than that."
Praeger says delaying the exchanges may be considered as the lame duck Congress looks for a way to stave off the mandatory budget cuts and tax hikes that go into under the "fiscal cliff."