The government's chief auditor on Wednesday said President Obama's health care overhaul is in danger of missing key October deadlines, raising concerns it could be the nightmare that Republicans and even some Democratic lawmakers have feared of late.
In one study released Wednesday, the Government Accountability Office offered a mixed review of the Obama administration efforts to make sure the "exchanges" — insurance markets where individuals and businesses can shop for health plans — will be open for enrollment by the Oct. 1 deadline.
In another study, the GAO said it was also worried about the deadlines for the Small Business Health Options Program, where small businesses can shop for coverage.
"Whether these efforts will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined," the GAO auditors said.
Among their concerns, auditors said the administration has yet to conduct final testing on a "data hub" that connects federal and state agencies, and steps to implement the Navigator program to offer in-person assistance to enrollees were delayed by two months and forced officials to consolidate two rounds of grant awards into one in August.
All sides are eyeing the deadlines, with Obama administration officials saying they will be ready in time.
But even as they push ahead, some lawmakers are scrutinizing the law and say changes are needed.
On Wednesday, two senators said that setting the law's threshold for calculating full-time work at 30 hours is pushing businesses to cut hours and stop growing.
Sens. Joe Donnelly, Indiana Democrat, and Susan M. Collins, Maine Republican, said employers should be allowed to calculate full-time employees based on a 40-hour workweek instead.
"This is not a hypothetical concern," Ms. Collins said.
Taken together, the developments highlighted the political stakes tied to the health care overhaul Congress passed in 2010, now that key implementation dates are mere months away.
The Congressional Budget Office has estimated that 7 million people will enroll in the exchanges in 2014, increasing to 24 million by 2022.
While the Obama administration and its nonprofit allies whip support for the law and educate Americans on its benefits, Republican lawmakers have seized on confusion about the law and studies such as Wednesday's GAO reports that lend credence to their gloomy prophecies.
"The law is indeed a train wreck with no relief in sight," Rep. Sam Graves, Missouri Republican and chairman of the House Small Business Committee, said Wednesday.
Rep. Jim McDermott of Washington, ranking Democrat on the Ways and Means Committee's health subcommittee, said the rollout is similar to Medicare, which saw hiccups but has turned into a popular program for seniors' health care.
"As the president has said, there will be bumps in the road but we will get there," he said. "Rather than scaring people, let's focus on the real work needed to make sure that this reform continues to help the millions of Americans it's intended to benefit."
Health and Human Services Secretary Kathleen Sebelius has repeatedly told federal lawmakers that the exchanges will be ready on time. She said Congress has not provided her agency with adequate funding.
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