White House Masked Fears of Obamacare Collapse

WASHINGTON, DC - APRIL 01: (L-R) Senior Advisor to the President Valerie Jarrett, White House Chief of Staff Denis McDonough, and Health and Human Services Secretary Kathleen Sebelius confer before U.S. President Barack Obama spoke on the Affordable Care Act with Vice President Joe Biden in the Rose Garden of the White House April 1, 2014 in Washington, DC. More than 7 million Americans signed up for health insurance through the final day of eligibility of the national health care law. 
National Journal
Major Garrett
April 1, 2014, 5:42 p.m.

The num­bers are still com­ing in on the Af­ford­able Care Act, and that will con­tin­ue for years.

There will nev­er be one num­ber that tells the full story of the law’s im­pact on health care costs, the un­der­ly­ing eco­nom­ic health of the law, its ef­fect on the fed­er­al de­fi­cit or job cre­ation. Obama­care will be a stat­ist­ic­al kal­eido­scope for its en­tire leg­al life — even after this Con­gress or an­oth­er changes it un­der polit­ic­al duress.

Even so, 7.1 mil­lion en­rollees is a mile­stone. It doesn’t guar­an­tee the law will work, and it doesn’t en­sure premi­ums won’t rise or doc­tors and nurses will be avail­able to provide the care prom­ised by the in­sur­ance ac­quired. But it does rep­res­ent a wa­ter­shed mo­ment in the White House ef­fort to pre­serve what it so con­spicu­ously and com­ic­ally jeop­ard­ized.

Press sec­ret­ary Jay Car­ney can­not stop in­vok­ing the word “re­mark­able” to de­scribe Obama­care’s comeback saga. What is so re­mark­able about an ad­min­is­tra­tion, with three years to plan, at­tain­ing the agreed-upon goal of en­rolling 7 mil­lion Amer­ic­ans? That was a num­ber that Health and Hu­man Ser­vices Sec­ret­ary Kath­leen Se­beli­us em­braced in con­gres­sion­al testi­mony and health care hands with­in the White House thought at­tain­able. The re­mark­able part is not the num­ber of en­rollees on March 31, but that it was achieved after an un­pre­ced­en­ted two-month act of self-sab­ot­age.

Hav­ing sur­vived that, Pres­id­ent Obama’s Rose Garden vic­tory lap — wit­nessed by Se­beli­us and White House Chief of Staff Denis Mc­Donough sit­ting to­geth­er in the front row — ended a telling chapter in Obama’s ap­proach to pres­id­en­tial lead­er­ship. Dur­ing the darkest days of the web­site melt­down, Obama made it clear to those who asked that it was cru­cial for him not to fire any high-rank­ing ad­min­is­tra­tion of­fi­cials. Se­beli­us and Mc­Donough both reas­on­ably feared they would be shown the door.

Nu­mer­ous busi­ness ex­ec­ut­ives, even those who wish Obama well, cri­ti­cized Obama pub­licly and privately for fail­ing to “hold someone ac­count­able” and us­ing the power of a bur­eau­crat­ic be­head­ing to demon­strate his fury. Wheth­er this is a sign of strength or weak­ness, it is char­ac­ter­ist­ic­ally Obama.

Hold­ing a ma­ligned, self-doubt­ing team to­geth­er in mo­ments of per­il is too of­ten over­sim­pli­fied by the phrase “No Drama Obama.” It’s more com­plex than that. Obama has con­vinced him­self that scar­ing people with a ce­re­mo­ni­al fir­ing deep­ens fear, turns al­lies against one an­oth­er, makes them risk-averse, and saps pro­ductiv­ity. At no time was this dis­til­la­tion of pres­id­en­tial power put to more strenu­ous ad­min­is­tra­tion-wide test. In­ter­est­ingly, it was Mc­Donough, on a walk Monday at dusk on the South Lawn, who gave Obama the news that en­roll­ment fig­ures were sure to top 7 mil­lion.

“At times this re­form has been con­ten­tious and con­fus­ing, and ob­vi­ously it’s had its share of crit­ics,” Obama said in the Rose Garden. “That’s part of what change looks like in a demo­cracy. Change is hard. Fix­ing what’s broken is hard. Over­com­ing skep­ti­cism and fear of something new is hard. And a lot of times, folks would prefer the dev­il they know to the dev­il they don’t. But this law is do­ing what it’s sup­posed to do. It’s work­ing.”

In ways they’ve nev­er dis­cussed be­fore, seni­or ad­min­is­tra­tion of­fi­cials now ad­mit they feared late last fall that the en­tire law might col­lapse un­der the weight of Demo­crat­ic de­fec­tions and ag­gress­ive Re­pub­lic­an calls for re­peal. The math­em­at­ics of veto-proof ma­jor­it­ies al­ways ar­gued against re­peal, but the night­mare of Health­Care.gov fol­lowed by the “polit­ic­al lie of the year” on in­di­vidu­al in­sur­ance policies filled seni­or Obama ad­visers with Af­ford­able Care Act ex­ist­en­tial dread.

Look­ing back on it now, seni­or of­fi­cials heap praise on the triage team led by Jef­frey Zi­ents that re­built the web­site. But they also pro­claim with jut-jawed ar­rog­ance this un­as­sail­able and in ret­ro­spect vi­tal polit­ic­al fact: Not one Sen­ate Demo­crat who voted for Obama­care and only two House Demo­crats (Jim Math­eson of Utah and Mike McIntyre of North Car­o­lina) ever backed full re­peal. That real­ity wasn’t al­ways a sure thing. The party dis­cip­line on re­peal re­flects the tenacity of the Demo­crats who drove it through every le­gis­lat­ive obstacle: House Minor­ity Lead­er Nancy Pelosi and Sen­ate Ma­jor­ity Lead­er Harry Re­id.

Obama made calls and held some hands. But Pelosi and Re­id ran rough­shod on the un­settled, her­ded the doubt­ful, and schooled the un­wit­ting in the grue­some polit­ics of pun­ish­ing trait­ors.

Pelosi met with Obama at the White House Tues­day, and I asked her if she ever feared Obama­care would col­lapse. “Nev­er,” she said. “It nev­er for one in­stant oc­curred to me that the Af­ford­able Care Act would col­lapse. Yes, the web­site didn’t per­form. We were very dis­ap­poin­ted. It was an em­bar­rass­ment. But it was an epis­ode, and it’s over. And you can’t be afraid of one thing or an­oth­er. I didn’t even know that that was the mood in the White House. That’s news to me. I nev­er shared that.”

It’s easi­er now, in ret­ro­spect, to de­clare such anxi­ety un­think­able. But it was real in­side the White House and Demo­crat­ic cloak­rooms. For the White House, talk of vul­ner­able Demo­crats run­ning away from Obama­care in the midterms sounds al­most quaint. They know the real danger of Demo­crats run­ning away was in Novem­ber and Decem­ber. If they didn’t cut and run then, they’re un­likely to do so now. And the polit­ics now are even sim­pler than then. Does a Demo­crat be­lieve he or she can run against Obama­care and at­tract the Obama co­ali­tion?

The White House doesn’t. And un­like Re­pub­lic­an strategists, it and Pelosi and Re­id have stared down po­ten­tial de­fect­ors. Dur­ing Obama­care’s worst days, Obama kept his team in place, and so did Re­id and Pelosi. The law and its num­bers, the re­vi­sions and delays will con­tin­ue to un­fold month by month and year by year. But the story of hold­ing the Demo­crats to­geth­er on Obama­care is as it was from the start: Obama-Pelosi-Re­id, a con­stel­la­tion of con­stancy amid the chaos.

The au­thor is Na­tion­al Journ­al cor­res­pond­ent-at-large and chief White House cor­res­pond­ent for CBS News. He is also a dis­tin­guished fel­low at the George Wash­ing­ton Uni­versity School of Me­dia and Pub­lic Af­fairs.

COR­REC­TION: An earli­er ver­sion of this story in­cor­rectly said that no House or Sen­ate Demo­crat backed re­peal of Obama­care. In fact, two House Demo­crats — Jim Math­eson of Utah and Mike McIntyre of North Car­o­lina — did.

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