3 Questions About Obamacare for Obama and the GOP

Why didn’t the president know more and why won’t GOP governors do more?

US Republican presidential candidate and former Massachusetts Governor Mitt Romney (2nd L) waves alongside Ohio Republican Senator Rob Portman (L) and Ohio Governor John Kasich (R) during a campaign stop at Tom's Ice Cream Bowl in Zanesville, Ohio, on August 14, 2012.
National Journal
Ron Fournier
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Ron Fournier
Oct. 23, 2013, 4:16 a.m.

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.

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