Peggy Salvatore of Healthcare Talent Transformation did an excellent job with the Health Wonk Review this week, taking us on a legislative and healthcare policy roadtrip with lots of interesting stops along the way. She starts things off with Brad Wright’s concise summary of why a government shutdown on October 1 won’t do much to hinder the implementation of Obamacare (and congratulations to Brad on 700 blog posts!). A government shutdown would cause all sorts of disruptions in other areas, so it’s definitely a case of Congress cutting off its nose to spite its face. Although we’re only a few days away the scheduled opening day for the marketplaces/exchanges, conservative lawmakers 
continue to do everything they can to try to derail the ACA. They’ve voted to defund the law 42 times, and are apparently not above shutting down all sorts of government services in order to make their point.
But in states like Colorado, where we’re running our own marketplace (Connect for Health Colorado) that was created with our own state law, I can’t imagine turning back at this point. I’m sure it’s different in states that have resisted the ACA from the start, but Colorado is ready for all of the provisions that the marketplace will bring. No more medical underwriting. Subsidies to help pay for health insurance and reduce out of pocket expenses. A 3 to 1 cap on the amount that older people can be charged for health insurance when compared with younger members. No more lifetime or annual limits (mostly already in place, but there are still some annual limits in place that will be phased out as the plans renew in 2014). Young people who are able to remain on their parents’ health insurance instead of going uninsured if their employer doesn’t offer coverage (jobs that don’t offer coverage tend to be entry-level, so these demographics overlap quite often).
There will probably be some hiccups as the marketplaces get underway next week. But it’s an exciting time for all of the people who have been unable to afford health insurance or unable to qualify for a policy because of medical underwriting. Between guaranteed issue and subsidies, a lot of them will finally be able to have health insurance. Whether or not we’ll be able to visit Rocky Mountain National Park as it gets back up and running after the recent flooding is up to our fearless leaders in Congress.
