The federal government has shut down, but the health insurance exchanges opened for business as planned Tuesday, although with traffic tie-ups, despite Republican lawmakers' efforts to block a major component of the health reform law from taking effect.
"An important part of the Affordable Care Act takes effect...no matter what Congress decides to do," President Barack Obama said in a statement on Monday. "The Affordable Care Act is moving forward. That funding is already in place. You can't shut it down."
House Republicans had tied continued funding of government operations beginning Oct. 1, the start of the federal fiscal year, to defunding or delaying the Affordable Care Act and limiting the birth control provisions of the law. The president said that the shutdown was preventable if the House would pass a clean bill to fund agencies without "extraneous and controversial demands."
The president noted that the law has passed Congress and been upheld as constitutional by the Supreme Court, and that he was re-elected in November.
While surveys continue to show that Americans are still confused or uninformed about the ACA and the exchanges, as more people begin to use it – and if they find it a positive experience – critics will have shrinking leverage with which to hinder it, going the way of other transformative programs, such as Medicare and Medicare Part D for prescription drugs.
Some ACA provisions have already been in effect, including young adults being able to stay on their parents' plan until they are 26, seniors getting lower-cost prescription drugs by bridging the so-called "donut hole," and prohibiting insurers from imposing lifetime caps on those already insured and requiring that they apply at least 80 percent of premiums to medical care delivery.
The federal website www.healthcare.gov was available for individuals looking for information about exchanges and for enrollees in states that chose not to develop their own exchange. The portal links them to information about plans available to them once they type in their state. State exchange portals were up and running, with some reports of heavy online traffic to them.
Instead of being blocked from health insurance exchanges, Americans on Tuesday found themselves barred from national parks and museums, from applying for passports and mortgage or small business loan applications under federal programs, and from obtaining a gun permit that must be processed through the Bureau of Alcohol, tobacco, Firearms and Explosives (ATF) because of the shutdown.
It is uncertain how long the shutdown will go on. The last federal shutdown was 17 years ago during the Clinton administration.