Why Obama Should Be Freaked Out Over Obamacare

It’s worse than we know, this is the easy part, and millions of Americans could be hurt.

President Barack Obama meets with House Democratic leaders in the Oval Office at the White House October 15, 2013 in Washington, DC.
National Journal
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Ron Fournier
Oct. 21, 2013, 6:08 a.m.

Pres­id­ent Obama said Monday he’s “frus­trated” by the dis­astrous launch of an on­line com­puter mar­ket­place for Obama­care. Here are five reas­ons why frus­tra­tion isn’t enough. He should be frightened.

1. It’s worse than his team has let on. The White House has tried to po­s­i­tion the failed first days of Obama­care as mere hic­cups caused by the site’s pop­ular­ity. Obama called them “kinks.” An ad­min­is­tra­tion spokes­man told the Wash­ing­ton Post on Sunday that the “main driver of the prob­lem is volume.” This is in­ten­tion­ally mis­lead­ing. 

The White House has heard com­plaints from in­sur­ance com­pan­ies, con­sumers, and health policy ex­perts about is­sues em­bed­ded deeply in the on­line sys­tem. For ex­ample: in­ac­cur­ate in­form­a­tion provided to people about fed­er­al tax cred­its; low-in­come people er­ro­neously told they don’t qual­i­fy for Medi­caid; and in­sur­ance com­pan­ies get­ting con­fus­ing in­form­a­tion about who has signed up.

The ad­min­is­tra­tion re­fuses to say how many people have en­rolled through the fed­er­al ex­change, the key met­ric for de­term­in­ing how well the on­line ser­vice is work­ing in states that didn’t set up their own ex­changes. There are two pos­sible ex­plan­a­tions for the Obama ad­min­is­tra­tion’s un­con­scion­able lack of trans­par­ency. Their pro­cess is so screwed up that they don’t have the data, which would be em­bar­rass­ing. Or they have the data ““ and it’s em­bar­rass­ing.

2. This is the easy part. Find­ing and mo­tiv­at­ing people to take ac­tion on­line is the found­ing strength of Team Obama. This is what they do best. Man­aging a com­plex law is a dif­fer­ent mat­ter, and it’s fair to ques­tion wheth­er the pres­id­ent and his team are up to it.

How do you con­vince healthy young Amer­ic­ans to pay for in­sur­ance they may not need in or­der to fund the pro­gram? Do com­pan­ies shed work­ers and work­ing hours to avoid com­ing un­der the law? Are people with cheap cata­stroph­ic plans forced to pay more in the ex­changes? Tricky ques­tions likes these will soon make the hard art of web­site design look like fin­ger­paint­ing. “The on­line fed­er­al health care ex­change, the heart of the Obama­care pro­ject, is such a rolling cata­strophe that it may end up cre­at­ing a ma­jor policy fiasco im­me­di­ately rather than even­tu­ally,” wrote Ross Douthat in a New York Times column titled, “Obama­care, Fail­ing Ahead of Sched­ule.”

3. It re­flects poorly on the pres­id­ent. Nobody ex­pects the chief ex­ec­ut­ive to be re­view­ing com­puter code or host­ing East Room “hack­a­thons.” But this falls on him. The CEO of a cor­por­a­tion or coun­try is uniquely re­spons­ible for mak­ing sure the team is on task, and he or she is ul­ti­mately re­spons­ible if it’s not. In Obama’s case, did he de­mand thor­ough up­dates on the pro­gress of the site? If so, did he ask the right ques­tions? Did he put the right people on the job in the first place? Giv­en the hor­rid first days of Obama­care, the an­swer to at least one of those ques­tions must be “no.”

4. It re­flects poorly on gov­ern­ment. The pub­lic’s faith in gov­ern­ment is at a re­cord low, just as Obama is fight­ing Re­pub­lic­ans on sev­er­al fronts over the size and power of the fed­er­al bur­eau­cracy. His ad­min­is­tra­tion needs to rap­idly im­prove the on­line ex­changes to stand any chance of con­vin­cing, say, young Amer­ic­ans to pay for in­sur­ance they don’t think they need. Bey­ond Obama­care, the Demo­crat­ic Party’s repu­ta­tion for com­pet­ency is as stake.  The cost of the site is already $394 mil­lion, a massive amount com­pared to private-sec­tor CMS work, and sure to grow.

5. It could hurt Amer­ic­ans. For dec­ades, politi­cians in both parties pledged to ease one of the lead­ing causes of anxi­ety in the post-in­dus­tri­al age, the lack of af­ford­able health care. Nearly 50 mil­lion Amer­ic­ans are un­in­sured, or about 15.4 per­cent of the pop­u­la­tion. Mil­lions more are un­der­insured. Obama­care, en­acted three years ago over the ob­jec­tions of Re­pub­lic­ans, may or may not be the an­swer. But, as the White House likes to re­mind Re­pub­lic­ans, it’s the law and it de­serves a shot.

How sadly iron­ic it would be if Obama­care is denied a fair shake be­cause of its name­sake’s mis­man­age­ment.

“The Af­ford­ab­il­ity Care Act is not just a web­site,” Obama said Monday, “it’s much more.” True to a point, but the web­site is crit­ic­al to the law’s pur­pose: help­ing mil­lions of Amer­ic­ans bar­gain for bet­ter health care. Dis­miss­ing the ex­tent of the prob­lem and re­mind­ing voters that Re­pub­lic­ans fought the law — which is es­sen­tially all Obama did in his Rose Garden re­marks — is a de­flec­tion, which shouldn’t be con­fused with im­ple­ment­a­tion or gov­ern­ing.

NOTE: This story was up­dated after Obama’s re­marks.

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