Here are the biggest three questions Americans deserve to know about the incompetent management and craven politics behind the Affordable Care Act:
1. What did President Obama know (and why didn't he know more) about the broken website? The $400 million-plus online marketplace fueling his signature legislative achievement is a bust. Its failure threatens to undermine the public's confidence in Obamacare, which could dampen sign-up rates and undercut the goal of providing affordable health care to 40 million Americans. The site launched despite internal warnings that it was not ready. When did the president realize his site was a joke?
In "the first couple of days" after the site went live Oct. 1, Health and Human Services Secretary Kathleen Sebelius told CNN.
"But not before that?" CNN's Dr. Sanjay Gupta asked.
"No, sir," she replied.
That is either a lie, which would be unforgivable. Or it reveals an unfathomable lack of oversight. For a breakdown of this magnitude to go undetected by Sebelius and her boss, there must be severe gaps in the management systems of the Obama administration that any first-year MBA student could ferret out. Even Democrats are asking, how could they let this happen?
2. Why wasn't Jeffrey Zients brought in months ago? The White House announced Monday that the former acting director of the Office of Management and Budget will oversee the effort to fix the site. Zients, who also served as the White House's first chief performance officer, is an accomplished manager and trouble-shooter, the perfect talent to oversee the launch of a historic health care plan before it hits the skids. Sebelius didn't do her job, but still has one. What signal does that lack of accountability send to other leaders inside the Obama administration? What does it tell uninsured Americans about the president's ability and determination to implement his law?
3. Why are Republicans playing politics with Obamacare? For the act to benefit the largest number of uninsured Americans, states must expand Medicaid coverage to anyone who earns up to 133 percent of the federal poverty level in 2014, which is $15,282 for a single person this year. The U.S. Supreme Court allowed states to opt out of the provision. Determined to undermine the bill and deal Obama a political blow, Republican governors and legislators have refused to accept the federal dollars that would finance it. Millions of low-income Americans, mostly in the South, will remain uninsured, victims of zero-sum gain politics.
This week, Ohio Gov. John Kasich became the tenth Republican governors to defy his party and expand Medicaid, going against his Republican-led legislature. "I believe [expanding Medicaid] is a matter of life and death," Kasich told the Cincinnati Enquirer in July. "It's going to happen. It's just a matter of when." He's right. His Medicaid-denying colleagues are wrong.