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.

{{ BIZOBJ (video: 4711) }}

What We're Following See More »
Congress Passes Chemical Regulations Overhaul
15 minutes ago

The House on Tuesday voted 403-12 "to pass an overhaul to the nation’s chemical safety standards for the first time in four decades. The Frank R. Lautenberg Chemical Safety for the 21st Century Act aims to answer years of complaints that the Environmental Protection Agency lacks the necessary authority to oversee and control the thousands of chemicals being produced and sold in the United States. It also significantly clamps down on states’ authorities, in an effort to stop a nationwide patchwork of chemical laws that industry says is difficult to deal with."

GOP Could Double Number of Early Primaries
52 minutes ago

"Leaders of the Republican Party have begun internal deliberations over making fundamental changes to the way its presidential nominees are chosen, a recognition that the chaotic process that played out this year is seriously flawed and helped exacerbate tensions within the party." Among the possible changes: forbidding independent voters to cast ballots in Republican primaries, and "doubling the number of early states to eight."

Kasich Tells His Delegates to Remain Pledged to Him
2 hours ago

Citing the unpredictable nature of this primary season and the possible leverage they could bring at the convention, John Kasich is hanging onto his 161 delegates. "Kasich sent personal letters Monday to Republican officials in the 16 states and the District of Columbia where he won delegates, requesting that they stay bound to him in accordance with party rules."

House GOP Changes Rules for Spending Measures
2 hours ago

"Speaker Paul Ryan is changing the rules of how the House will consider spending measures to try to prevent Democrats from offering surprise amendments that have recently put the GOP on defense. ... Ryan announced at a House GOP conference meeting Tuesday morning that members will now have to submit their amendments ahead of time so that they are pre-printed in the Congressional Record, according to leadership aides." The change will take effect after the Memorial Day recess.

Sanders Wants a Recount in Kentucky
4 hours ago

Bernie Sanders "signed a letter Tuesday morning requesting a full and complete check and recanvass of the election results in Kentucky ... where he trails Hillary Clinton by less than one-half of 1 percent of the vote. The Sanders campaign said it has asked the Kentucky secretary of state to have election officials review electronic voting machines and absentee ballots from last week's primary in each of the state's 120 counties.