Congress Deserves Public’s Contempt for Its Obsession With Destroying Obamacare

WASHINGTON, DC - SEPTEMBER 25: U.S Sen. Ted Cruz (R-TX) leaves the Capitol after he spoke on the Senate floor for more than 21 hours September 25, 2013 on Capitol Hill in Washington, DC. Sen. Cruz ended his marathon speech against the Obamacare at noon on Wednesday. 
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Norm Ornstein
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Norm Ornstein
Jan. 8, 2014, 4 p.m.

Con­gress is back — and the House has an am­bi­tious plan for the year ahead. OK, an am­bi­tious plan to ce­ment its place in his­tory as the Do-Nothingest Con­gress of all time.

The House has sched­uled all of 97 days in ses­sion be­fore the Novem­ber elec­tions, with many of them be­ing half days or pro forma ones. And Ma­jor­ity Lead­er Eric Can­tor’s memo to his troops out­lining the plan for the year ahead made it clear that there is at most a bare-bones agenda, fo­cused like a laser, yet again, on re­peal­ing or fur­ther sul­ly­ing and del­e­git­im­iz­ing Obama­care. The only pos­sible good news com­ing out of that is that the ob­sess­ive fo­cus on killing Obama­care may provide the ex­cuse for House lead­ers to ex­tend the debt ceil­ing without black­mail this time, by con­vin­cing their rank-and-file that it is the best way to avoid dis­trac­tions and keep the fo­cus on the health in­sur­ance law.

The ob­ses­sion with Obama­care, and the near-uni­ver­sal be­lief among Re­pub­lic­an law­makers and con­ser­vat­ive spin­meisters that the law will col­lapse spec­tac­u­larly of its own weight, is fas­cin­at­ing.

Re­mem­ber that when Sen. Ted Cruz in­cited the shut­down last year over the de­mand to de­fund Obama­care, his ar­gu­ment was that this was the last chance be­fore the law was im­ple­men­ted in Janu­ary — after which it would be im­possible to stop it, be­cause so many Amer­ic­ans would be de­lighted with its be­ne­fits. Cruz told Sean Han­nity last Ju­ly, “If we don’t do it [de­fund Obama­care] now, in all like­li­hood, Obama­care will nev­er, ever be re­pealed. Why is that? Be­cause on Janu­ary 1, the ex­changes kick in, the sub­sidies kick in; … their plan is to get the Amer­ic­an people ad­dicted to the sug­ar, ad­dicted to the sub­sidies, and once that hap­pens, in all like­li­hood, it nev­er gets “¦”

At which point Han­nity agreed, say­ing, “It’s over — it nev­er gets re­pealed.”

The aw­ful and bumpy rol­lout of the plan changed all that; now, for Cruz, Han­nity, and every­one else in the right-wing echo cham­ber, there won’t be any highs ahead, or at least the highs and sug­ar ad­dic­tions will be over­whelmed by bad drugs and over­doses.

Which view is right? We don’t know for sure, but there is some in­ter­est­ing evid­ence in the rol­lout of the Medi­care Part D plan in 2005, via an ex­cel­lent ana­lys­is by Geor­getown Uni­versity’s Cen­ter on Health In­sur­ance Re­form. The re­port makes clear that there are many par­al­lels between Part D and Obama­care.

First, both plans passed with sub­stan­tial par­tis­an ten­sion, which tar­nished the ini­tial pub­lic views of them. Second, both plans cre­ated much con­fu­sion in the pub­lic, with small pro­por­tions of Amer­ic­ans hav­ing even a ba­sic un­der­stand­ing of what was in the plans and how they would work. Third, both plans had a lot of time after pas­sage and be­fore they ac­tu­ally took ef­fect to pre­pare for a massive rol­lout. Fourth, neither had its web­site ready to roll when the dead­line hit, and both had crashes and long delays to gain ac­cess. Fifth, even after the web­sites be­came more re­li­able, oth­er prob­lems per­sisted, in­clud­ing in­ad­equate call cen­ters and in­ex­per­i­enced nav­ig­at­ors at the loc­al level who were un­pre­pared with full or soph­ist­ic­ated an­swers to ques­tions posed by those try­ing to sign up. Sixth, sup­port­ers of the laws is­sued cau­tions when they were first un­veiled, warn­ing of glitches ahead and ask­ing the pub­lic for un­der­stand­ing and help at ameli­or­at­ing the prob­lems.

Now for the dif­fer­ences. While Medi­care Part D was the sub­ject of ser­i­ous par­tis­an chi­canery — the in­fam­ous three-hour vote in the House; the con­fer­ence com­mit­tee that barred key Sen­ate Demo­crats from par­ti­cip­at­ing, in­clud­ing Sen­ate Demo­crat­ic Lead­er Tom Daschle; the “bait and switch” that in the end took out all the parts of the bill that had made Ted Kennedy an ini­tial part­ner of the Bush ad­min­is­tra­tion — once it was law, most Demo­crats worked hard to make the plan ac­cess­ible and work­able for seni­ors, as did Demo­crat­ic gov­ernors and state le­gis­latures.

Of course, the op­pos­ite is true of Obama­care. Des­pite yeo­man ef­forts to make the bill bi­par­tis­an — months and months of ne­go­ti­ation by Sen­ate Fin­ance Chair­man Max Baucus with Chuck Grass­ley and oth­er Sen­ate Re­pub­lic­ans, start­ing from a frame­work de­vised and en­dorsed by Grass­ley — it got not a single GOP vote. But after pas­sage, it has re­ceived noth­ing but yeo­man ef­forts to sab­ot­age it, in­clud­ing from a slew of Re­pub­lic­an gov­ernors deny­ing in­sur­ance to the most needy of their con­stitu­ents simply to sty­mie the law’s im­ple­ment­a­tion. And whenev­er a Re­pub­lic­an talks about how to make the law work bet­ter, in­stead of blow­ing it up (Jack King­ston of Geor­gia comes to mind), he or she is vil­i­fied by par­tis­ans and their me­dia aco­lytes.

Second, the main­stream me­dia re­por­ted on the glitches in the Medi­care Part D plan but did not jump all over them with front-page or high­lighted stor­ies, or re­peated and lengthy in­quests on Sunday talk shows. The op­pos­ite has been true of Obama­care, with an ad­ded twist that re­flects the new eco­nom­ic and polit­ic­al real­it­ies for me­dia, as re­por­ted in a piece by Mag­gie Ma­har at health­in­sur­ance.org. Ma­har in­vest­ig­ated a bal­ly­hooed art­icle in the Fort Worth Star-Tele­gram titled “Obama­care Stirs Anxi­ety for Thou­sands.” The cases of those who were pur­portedly shaf­ted by Obama­care proved to be false or ex­ag­ger­ated, and three of the four cases cited were tea-party ad­her­ents who strongly op­posed the law, two of whom had nev­er even checked for prices on the ex­changes. After a lengthy stone­wall by the pa­per’s ed­it­ors, it be­came clear that no one had fact-checked the piece, which was writ­ten by a re­port­er with no ex­pert­ise in health policy, un­der a tight time frame, as­signed by an ed­it­or who only wanted bad news, not any stor­ies of those who had been helped by the new law. This is more a case of un­der­re­sourced news out­lets eager to re­port bad news than bi­as, but it re­flects the tough­er cli­mate for a law that af­fects far more people in far more ways than Part D did.

Eight years after its rocky rol­lout and deep pub­lic skep­ti­cism, the Medi­care Part D plan is widely pop­u­lar. I have no idea if that will be the case with Obama­care — and if achiev­ing pop­ular­ity takes any length of time, the polit­ic­al dam­age, in this Novem­ber elec­tion and maybe even in 2016, will already have been done. What I do know is that there are go­ing to be a whole lot of win­ners un­der the Af­ford­able Care Act, and a smal­ler num­ber, but still a sig­ni­fic­ant one, of losers or those caught up in the in­ev­it­able up­heav­al to the health care sys­tem.

And I know if your only le­gis­lat­ive or policy plan for 2014, in the face of a slug­gish eco­nomy, a crisis of long-term un­em­ploy­ment, and a host of oth­er short and long-term prob­lems fa­cing the coun­try, is to bet on the spec­tac­u­lar fail­ure of the health care plan, you de­serve the pub­lic con­tempt your Con­gress is re­ceiv­ing.

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