There’s a reason why President Obama and fellow Democrats insist the Affordable Care Act is more than a website.
A marginally unpopular law now offers in some states a hugely confusing and frustrating online enrollment experience that won’t be fixed tomorrow and has jeopardized the government’s second chance to make a first impression.
If October’s government shutdown drama represented a Republican decision to race into a brick wall, Obamacare’s implementation failures fall along the same lines for Democrats. And were equally avoidable.
Three weeks into implementation of the new insurance exchanges, problems with software, data security, bureaucratic integration, contractor responsibilities, and statutory deadlines are all on vivid display.
In the Rose Garden on Monday, the president was in full-bore damage-control mode, emphasizing two main messages. He said he is so displeased with the hobbled health insurance Web portal that he ordered every federal effort to repair the complex new system (he didn’t promise by when). And he insisted that despite all the problems with the enrollment, the overall law “is working just fine.”
“I think it’s fair to say that nobody is more frustrated by that than I am,” Obama noted, standing among 13 people who either signed up for new insurance or were in the process of doing so. “Precisely because the product is good, I want the cash registers to work. I want the checkout lines to be smooth. … There’s no excuse for the problems, and these problems are getting fixed,” he said.
After months of boasting that America’s uninsured would eventually buy health coverage after Oct. 1 as easily as searching for an airline ticket on Kayak.com, the president jettisoned that particular line of salesmanship. Instead, he touted the most popular coverage provisions of the law in effect for all Americans, plus anecdotes about persistent consumers who located affordable policies in the last three weeks.
Republicans, who shut down the government and flirted with default in an effort to repeal or delay the health law, vow they won’t let up. Congressional oversight is now the weapon of choice, and conservatives have made Health and Human Services Secretary Kathleen Sebelius a target. She’s agreed to testify on Capitol Hill next week, although House members sought information from her more quickly than that. Lawmakers’ questions to HHS and the White House are stacking up, while media reporting about the rocky Obamacare rollout is a steady diet on TV and in major newspapers.
Question: Because the affordability of insurance under the law hinges on insurance companies’ expectations of large pools of new customers, how many Americans to date have purchased coverage through the new exchanges? HHS, which reports that half a million people submitted applications for insurance, won’t say how many have purchased it. That detail won’t be revealed until mid-November, according to the White House.
Question: When will the health exchanges’ “glitches” be corrected? Various officials and contractors close to the project have indicated that necessary fixes, including corrected or additional software coding, could take weeks and perhaps months.
Question: Will the administration extend the law’s six-month enrollment period for consumers who haven’t been able to navigate the new Web-based system for the better part of a month? That will depend on whether the government can fix the most critical problems fast enough. “I’m not going to speculate,” Obama spokesman Jay Carney said.
Question: Will Americans, who are required by law to have basic health insurance by March 31 -- and in practical terms would need to hook up with insurance companies by Feb. 15 to meet that deadline -- be penalized if the government has not resolved problems in time? HHS will soon have new guidelines to explain that, Carney said.
“Americans who have access to affordable insurance would need to have insurance by March 31,” he said. “People who do not have access to affordable care due to a state not expanding Medicaid, for example, or due to other factors will not be penalized.” (At least 22 states have declined or are leaning toward saying “no” to an expansion of Medicaid under the Affordable Care Act. And the “other factors” Carney mentioned could become a policy opening to watch, should the administration opt to adjust the individual mandate or penalty structure because a six-month enrollment period has been truncated by federal implementation errors.)
It may be that Obama is overly optimistic that the effectiveness of his signature legislative achievement is not bound up with the effectiveness of the federal portal built to sell that insurance. In other words, his boast that Obamacare is working “just fine” could be a wee bit premature.
Democrats had been making progress, at least in terms of public opinion during the GOP’s most assertive “repeal it” phase. Most Americans told pollsters they wanted the Affordable Care Act implemented effectively and improved as needed. And at least through the first week after the Healthcare.gov website launched, the public put its collective weight behind Democrats to do a better job than Republicans of implementing the law, according to a national survey of voters conducted Oct. 6-8 by Greenberg Quinlan Rosner for Democracy Corps.
“The debate ahead is about implementation of the Affordable Care Act,” the Democratic pollsters explained earlier this month. “When that is the choice, voters trust Democrats by 17 points (49 to 32 percent) to do a better job. The more Republicans make the period ahead about blocking implementation, the more they trust Democrats to do a better job in government.”
The administration’s stumbles while launching the law’s expanded coverage -- however temporary -- opened a new doorway to the law’s critics. Republicans, in effect, wriggled free of the administration’s assertions that conservatives wanted nothing more than to “block” Americans from receiving the benefits of better private-sector health insurance. The administration made it possible for the GOP to argue, instead, that it seeks to “safeguard” the public from the flawed execution of a byzantine insurance bazaar, “unfair” mandates, and inflexible IRS penalties.
The president’s urgent tone on Monday of “I’m-as-fed-up-as-you-America!” reflected some of the administration’s obvious mistakes while selling Obamacare to the public after its enactment three years ago.
“It’s time for folks to stop rooting for its failure,” Obama insisted, “because hardworking, middle-class families are rooting for its success. And if the product is good, they're willing to be patient.”
Every Democratic candidate heading into next year’s midterms -- and especially those who voted for Obamacare -- prays he is right about patience.
Obama’s own legacy is grafted to that bet.
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