The Obamacare Debate Is Not Over, Mr. President

On Obamacare, millions of Americans are signed up but not sold.

WASHINGTON, DC - NOVEMBER 14: U.S. President Barack Obama speaks on the Affordable Care Act in the White House briefing room November 14, 2013 in Washington, DC. The president said 'This one is on me,' and announced that canceled insurance plans would be renewed for a year.
National Journal
Ron Fournier
April 29, 2014, 4:26 a.m.

Pres­id­ent Obama con­fuses high en­roll­ment num­bers with suc­cess on Obama­care, ig­nor­ing the ob­vi­ous fact that mil­lions of Amer­ic­ans are signed up but not sold.

“The point is, the re­peal de­bate is and should be over. The Af­ford­able Care Act is work­ing,” the pres­id­ent said while an­noun­cing the en­roll­ment of more than 8 mil­lion Amer­ic­ans. That is not the point. The de­bate is not over.

The fact is that Amer­ic­ans are re­quired un­der the ACA to ob­tain health in­sur­ance or pay a tax. After a rocky launch, the ad­min­is­tra­tion cleared the first and easi­est hurdle in a long road to im­ple­ment­a­tion: En­for­cing a man­date.

Now the White House has to show that a massive new mar­ket­place, over­seen by a dis­trus­ted fed­er­al gov­ern­ment, can shrink the pool of un­in­sured without en­ra­ging the ma­jor­ity of people who are re­l­at­ively happy with their status quo. This is the hard part that Obama glossed over when he disin­genu­ously prom­ised voters that they could keep their doc­tor and in­sur­ance plans if they liked them. Rather than hon­estly ex­plain the com­plic­ated law and ask for pa­tience and shared sac­ri­fice, the pres­id­ent dis­sembled.

And now he pays.

A new Wash­ing­ton Post-ABC poll shows that Amer­ic­ans aren’t buy­ing Obama’s latest spin, his clos­ing the door on de­bate, es­pe­cially when it comes to the qual­ity and cost of their own health care.

  • By a two-to-one mar­gin, more people think the qual­ity of care they re­ceive is get­ting worse rather than bet­ter un­der Obama­care (29 per­cent to 14 per­cent). A ma­jor­ity says the qual­ity has stayed the same.
  • By a two-to-one mar­gin, more people think the na­tion’s health care sys­tem is get­ting worse, not bet­ter (44 per­cent to 24 per­cent). Less than a third say the qual­ity of U.S. health care is about the same.
  • Nearly half of Amer­ic­ans say their per­son­al health care costs are in­creas­ing un­der Obama­care (47 per­cent). Just 8 per­cent re­port de­creases.
  • A strong ma­jor­ity say the over­all costs of the U.S. health care sys­tem are in­creas­ing (58 per­cent). Just 11 per­cent see de­creases.
  • Des­pite the fact that the ad­min­is­tra­tion hit its first en­roll­ment goals, half of those polled said ACA im­ple­ment­a­tion is go­ing worse than they ex­pec­ted. Four-in-10 say the start has ex­ceeded ex­pect­a­tions.
  • Roughly the same per­cent­age of people sup­port the law as op­pose it (44 per­cent to 48 per­cent).
  • Just 37 per­cent ap­prove of how Obama has handled his sig­na­ture le­gis­lat­ive achieve­ment.

None of this means that Obama­care is doomed. The pres­id­ent has shuffled his team to put ex­per­i­enced man­agers in po­s­i­tion to nav­ig­ate the tough policy and polit­ics ahead. Voters may even­tu­ally give him cred­it for stretch­ing the safety net in­to the 21st cen­tury. And rival Re­pub­lic­ans risk over­reach­ing: Op­pos­ing health care to mil­lions is not a polit­ic­al slam dunk. Sev­er­al polls show that most voters, even in con­ser­vat­ive states, op­pose re­peal­ing the law.

Strictly speak­ing, that was Obama’s point when he said “the re­peal de­bate” is over, but the White House’s cel­eb­rat­ory re­sponse to the en­roll­ment achieve­ment had the un­mis­tak­able air of a vic­tory lap. The pres­id­ent risks in­sult­ing a vast ma­jor­ity of Amer­ic­ans by dis­miss­ing their con­cerns with a con­sult­ant’s talk­ing point. The de­bate is not over. It has just be­gun, and Obama can’t af­ford any more blows to his cred­ib­il­ity.

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