California Healthline: How California Took the ‘Lead’ on Obamacare — and Why It’s Too Early To Take a Victory Lap

by Dan Diamond, California Healthline Contributing Editor

Joel Ario says he meant it as a compliment.

It was January 2011, and Ario — the White House’s point man on exchanges at the time — was having dinner with Diana Dooley, California’s newly installed HHS secretary. And seeking to praise California, Ario told Dooley that her state had emerged as one of the nation’s “pace cars” when it came to implementing the Affordable Care Act.

Dooley quickly corrected him, Ario recalled in an interview with California Healthline this week.

“[Dooley] told me, ‘Pace cars don’t actually win the race,'” Ario said. “‘We want to be the lead car.'”

Forty months later, California’s clearly pulled ahead of the pack.

No state signed up more residents during Obamacare’s first open enrollment period, or grew its Medicaid rolls by a larger amount.

But not all glitters in the Golden State. While Covered California drove national enrollment — nearly one in five of all 8 million national ACA sign-ups went through the state’s insurance exchange — its faltering website and sometimes spotty service made for an occasionally bumpy ride.

“Road to Reform” interviewed Ario and more than 10 other ex-officials and experts — many of whom also spoke with California Healthline last fall on the eve of open enrollment — to assess the state of the state’s Obamacare implementation, and what roadblocks loom ahead.

How California Grabbed Pole Position

As many of those experts predicted in interviews last fall, California’s early investments ended up staking the state to its later lead. 


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