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A Better Obamacare Won’t Save Obama A Better Obamacare Won’t Save Obama

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White House

A Better Obamacare Won’t Save Obama

The website can be fixed, and the Affordable Care Act can start working as intended, but the damage is done—and the president might be, too.

(JEWEL SAMAD/AFP/Getty Images)

photo of James Oliphant
November 26, 2013

A new CNN poll confirms what America's collective gut has been saying for weeks: Obamacare is sinking its namesake.

The numbers are ugly: Just one in four respondents say President Obama is a competent manager of the federal government. For all the hand-wringing about comparing the HealthCare.gov site rollout to Hurricane Katrina, the bottom line is that this president, like his predecessor, has now suffered a signature event that has convinced a majority of Americans that he is unfit for the job.

Piling on, the president also scored his lowest marks on honesty and trustworthiness, with 53 percent of those surveyed responding that they don't feel Obama is being straight with them. To put it in some context, Bill Clinton was widely viewed as shifty but competent, and Jimmy Carter as honest but hapless. Obama at the moment seems to have combined the worst of both worlds.

 

The CNN results amplify Obama's political problem: The Affordable Care Act imbroglio is having an outsized effect on his entire presidency, with voters reassessing his basic qualifications. "This is serious," says Chris Kofinis, a Democratic strategist and former chief of staff to Sen. Joe Manchin of West Virginia. "This is much more serious than I hear some Democrats saying publicly. This is not a temporary drop."

Adds John Geer, an expert on public opinion at Vanderbilt University, "In a sense, the public was collectively willing to be patient. That reservoir of support among independents and moderates has evaporated."

For weeks, Democrats have hewn to the party line, arguing that once the website woes are repaired and people can enroll easily, the political climate will improve. And Kofinis is in that lot: "Fixing it will help turn it around. But not overnight. It's a lot easier to fall—a lot harder to come back."

But there are also plenty of reasons to believe that Obama won't recover to any great degree—reasons beyond history, which has shown that once presidents tumble to this level, they rarely, if ever, return to their previous heights.

One is the fickle nature of news coverage and the preference for anecdote over pattern. So if this week's deadline comes along and the federal health care exchange works smoothly, it's a one or two-day story, maybe a week. It's not a seven-week story, as the Keystone Kops-style implementation has been. And if the Nov. 30 deadline arrives and industrious reporters can document consumers still having troubles with the site, then all the administration's talking points about improvement will be rendered effectively inert.

But there is a more fundamental reason why the president is going to have a tough time bouncing back from this: To most Americans, Obamacare remains an abstraction. The direct benefits of the law are imparted to a relatively tiny part of the population. Only 12 million Americans are expected to use federal and state insurance exchanges to purchase coverage—that's about 4 percent of the country. And it's possible many of them have already received cancellation notices along with notices of rate hikes, which means their attitudes toward the ACA are, for want of a better word, complex.

At the same time, about 13 million Americans are expected to benefit from the expansion of the Medicaid program. Add those two cohorts together and you end up with about 25 million who receive a direct, substantive benefit from the ACA. That's less than 10 percent of the population and compared with those who benefit from Medicare (49 million) and Social Security (62 million), or even Medicare Part D (36 million), a thin slice of the electorate. More significant, just about every American will ultimately take advantage of those three entitlements; this is not true for the ACA.

What it all means is that even if the Affordable Care Act works perfectly from Nov. 30 on(and no one is seriously expecting that), those whose lives are improved by the program represent just a relative handful of people, many of whom sit at the lower end of the economic spectrum and engage little with the political process. As Geer says, "They tend not to vote."

And that's what's going to make any sort of renewed national sales pitch by Obama so difficult. Among the politically active, the damage is done, and no amount of rebranding or reselling is going to change their perception of the product—nor likely, the president.

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