Why I’m Getting Sick of Defending Obamacare

Incompetence, politics, and delays frustrate advocates of health care reform.

WASHINGTON - OCTOBER 29: U.S. President Barack Obama speaks to the media at the briefing room of the White House October 29, 2010 in Washington, DC. Obama made a statement regarding the suspicious packages that were found on cargo planes from Yemen heading to the United States. (Photo by Alex Wong/Getty Images)
National Journal
Ron Fournier
Feb. 11, 2014, 3:17 a.m.

It’s get­ting dif­fi­cult and slink­ing to­ward im­possible to de­fend the Af­ford­able Care Act. The latest blow to Demo­crat­ic can­did­ates, lib­er­al act­iv­ists, and naïve colum­nists like me came Monday from the White House, which an­nounced yet an­oth­er delay in the Obama­care im­ple­ment­a­tion.

For the second time in a year, cer­tain busi­nesses were giv­en more time be­fore be­ing forced to of­fer health in­sur­ance to most of their full-time work­ers. Em­ploy­ers with 50 to 99 work­ers were giv­en un­til 2016 to com­ply, two years longer than re­quired by law. Dur­ing a year­long grace peri­od, lar­ger com­pan­ies will be re­quired to in­sure few­er em­ploy­ees than spelled out in the law.

Not co­in­cid­ent­ally, the delays punt im­ple­ment­a­tion bey­ond con­gres­sion­al elec­tions in Novem­ber, which raises the first prob­lem with de­fend­ing Obama­care: The White House has politi­cized its sig­na­ture policy.

The win-at-all-cost men­tal­ity helped cre­ate a cul­ture in which a par­tis­an-line vote was deemed suf­fi­cient for passing tran­scend­ent le­gis­la­tion. It spurred ad­visers to de­vel­op a dis­hon­est talk­ing point — “If you like your health plan, you’ll be able to keep your health plan.” And polit­ic­al ex­pedi­ency led Obama to re­peat the line, over and over and over again, when he knew, or should have known, it was false.

De­fend­ing the ACA be­came pain­fully harder when on­line in­sur­ance mar­kets were launched from a multi-mil­lion-dol­lar web­site that didn’t work, when autop­sies on the ad­min­is­tra­tion’s ac­tions re­vealed an epi­dem­ic of in­com­pet­ence that began in the Oval Of­fice and ended with no ac­count­ab­il­ity.

Then of­fi­cials star­ted fudging num­bers and mas­sa­ging facts to pro­mote im­ple­ment­a­tion, noth­ing il­leg­al or even ex­traordin­ary for this era of spin. But they did more dam­age to the cred­ib­il­ity of ACA ad­voc­ates.

Fi­nally, there are the ACA rule changes — at least a dozen ma­jor ad­just­ments, without con­gres­sion­al ap­prov­al. J. Mark Iwry, deputy as­sist­ant Treas­ury sec­ret­ary for health policy, said the ad­min­is­tra­tion has broad “au­thor­ity to grant trans­ition re­lief” un­der a sec­tion of the In­tern­al Rev­en­ue Code that dir­ects the Treas­ury sec­ret­ary to “pre­scribe all need­ful rules and reg­u­la­tions for the en­force­ment” of tax ob­lig­a­tions, ac­cord­ing to The New York Times.

Yes, Obama­care is a tax.

Ad­voc­ates for a strong ex­ec­ut­ive branch, in­clud­ing me, have giv­en the White House a pass on its rule-mak­ing au­thor­ity, be­cause im­ple­ment­ing such a com­plic­ated law re­quires flex­ib­il­ity. But the law may be get­ting stretched to the point of break­ing. Think of the ACA as a game of Jenga: Ad­just one piece and the rest are af­fected; ad­just too many and it falls.

If not il­leg­al, the changes are fuel­ing sus­pi­cion among Obama-loath­ing con­ser­vat­ives, and con­fu­sion among the rest of us. Even the law’s most fer­vent sup­port­ers are frus­trated.

Ron Pol­lack, ex­ec­ut­ive dir­ect­or of the con­sumer lobby Fam­il­ies USA and an ally of the White House, told The Wash­ing­ton Post he was “very sur­prised” by the latest delays. For work­ers at large com­pan­ies that don’t provide cov­er­age, he said, “It’s very un­for­tu­nate “¦ that they don’t have a guar­an­tee it will be ex­ten­ded to them for quite some time.”

Put me in the frus­trated cat­egory. I want the ACA to work be­cause I want health in­sur­ance provided to the mil­lions without it, for both the mor­al and eco­nom­ic be­ne­fits. I want the ACA to work be­cause, as Charles Lane wrote for The Wash­ing­ton Post, the link between work and in­sur­ance needs to be broken. I want the ACA to work be­cause the GOP has not offered a ser­i­ous al­tern­at­ive that can pass Con­gress.

Un­for­tu­nately, the pres­id­ent and his team are mak­ing their good in­ten­tions al­most in­defens­ible.

COR­REC­TION: A pre­vi­ous ver­sion of this column in­ac­cur­ately es­tim­ated the cost of Health­Care.gov.