More than just a website: state efforts to make the ACA work (and the lack thereof)

We've all read by now that the ACA websites in states that are running their own exchanges (14, plus D.C.) are working much better than the federal site. What most of us may not have fully recognized -- though it's no doubt obvious to health and insurance professionals and people who have run social service programs -- is that establishing, running and marketing a functioning insurance marketplace requires a wholehearted commitment from state government.

Enticing insurers, policing insurers, and, above all, educating and wooing the uininsured public require expertise, commitment, money and accountability. Putting the program across in mostly low-income and low-information populations is a lot like delivering chronic care to those in need: it requires a lot of patient, informed, sensitive one-on-one contact.

Kentucky and California are two states that are going all out to make the Affordable Care Act a success.  The Huffington Post's Jason Cherkis recently did some great reporting in Kentucky, where Governor Steve Besheare, a Democrat,

is using all the powers of his administration to sell Obamacare, marshaling millions of dollars for branding and market research, heartwarming television spots and eye-catching bus ads. A hired army of true believers have held meetings across the state, spreading the word and rebutting misconceptions.