Obamacare Survives, Now Can It Be Fixed?

8 questions and 1 suggestion for durable health care reform.

Secretary of Health and Human Services Kathleen Sebelius speaks during an event in the East Room of the White House February 27, 2014 in Washington, DC.
National Journal
Ron Fournier
March 31, 2014, 5:18 a.m.

Pres­id­ent Obama and his team de­serve cred­it for pulling Obama­care from the brink of dis­aster. Wheth­er it lives to die an­oth­er day de­pends on the an­swer to these and oth­er ques­tions.

1. What are the real num­bers? There is no dis­put­ing that Af­ford­able Care Act sign-ups surged in the past few weeks, des­pite a de­plor­able rol­lout in late 2013. But we won’t know for weeks wheth­er the ad­min­is­tra­tion ac­com­plished its goal of adding 7 mil­lion people to the in­sur­ance rolls, in­clud­ing a plur­al­ity of healthy young adults. The num­bers an­nounced Tues­day, while im­press­ive, are in­com­plete and mis­lead­ing.

2. How will Amer­ic­ans re­spond when their monthly in­sur­ance premi­ums in­crease next year for health plans sold through fed­er­al and state mar­ket­places? The Wash­ing­ton Post noted today that many plans “low-balled” the prices for 2014 to at­tract cus­tom­ers. Premi­ums go up every year, but now the rates are linked to the suc­cess or fail­ure of the ACA mar­ket­places. Double-di­git in­creases are pos­sible.

3. Will the Demo­crat­ic Party suf­fer a re­verse halo af­fect? That is, will voters so as­so­ci­ate Obama’s party with health care that any prob­lems with the sys­tem — everything from high premi­ums to smug doc­tors — get placed at Demo­crats’ feet?

4. Who will get more at­ten­tion — the people who had their plans can­celed and pay more for an equi­val­ent policy that doesn’t in­clude their doc­tor? Or people with preex­ist­ing con­di­tions or young-adult chil­dren who be­ne­fit dir­ectly from the ACA?

5. How will Amer­ic­ans re­spond when they start get­ting fined for re­fus­ing to buy in­sur­ance?

6. Will Re­pub­lic­ans pay a price for block­ing Medi­caid ex­pan­sion in states? If not, will these holes in the sys­tem un­der­mine ACA?

7. Will the GOP win the Sen­ate and gain seats in the House by cam­paign­ing against Obama and his sig­na­ture policy? That out­come is a bit more likely than not. If Re­pub­lic­ans romp in Novem­ber and then win the pres­id­ency in 2016, the law could be dis­mantled.

8. Will com­mon sense pre­vail over par­tis­an­ship? As my col­league Sam Baker noted, “Re­pub­lic­ans pre­dicted it would col­lapse on it­self (didn’t hap­pen), while Demo­crats swore the pub­lic would em­brace it as time went on (also didn’t hap­pen).” The par­tis­ans were wrong (again), be­cause the truth lurks in the middle:

  • The na­tion needs a uni­ver­sal health care sys­tem.
  • A flawed ACA is the best ap­proach that a di­vided and dys­func­tion­al Wash­ing­ton could pro­duce at the time.
  • But for Obama­care to be a dur­able re­form, the ACA needs polit­ic­al and policy in­put from Re­pub­lic­ans. Demo­crats need to be will­ing to cede some con­trol, and Re­pub­lic­ans need to re­spons­ibly ac­cept it.

That’s not go­ing to hap­pen any time soon. Not when “fix it” is an empty elec­tion-year slo­gan for the Demo­crat­ic Party, and when gov­ern­ing from Wash­ing­ton is im­possible for the GOP.

{{ BIZOBJ (video: 4850) }}

What We're Following See More »
FRENCH IS A LAWYER, VETERAN
Kristol Recruiting National Review’s David French for Third-Party Run
2 hours ago
THE LATEST

"Two Republicans intimately familiar with Bill Kristol’s efforts to recruit an independent presidential candidate to challenge Donald Trump and Hillary Clinton have told Bloomberg Politics that the person Kristol has in mind is David French -- whose name the editor of the Weekly Standard floated in the current issue of the magazine.

French is a veteran of Operation Iraqi Freedom. According to the website of National Review, where French is a staff writer, he is a constitutional lawyer, a recipient of the Bronze Star, and an author of several books who lives in Columbia, Tenn., with his wife Nancy and three children."

Source:
CALIFORNIA VOTES IN A WEEK
Jerry Brown Backs Clinton
4 hours ago
THE LATEST

California Gov. Jerry Brown endorsed Hillary Clinton today, calling her "the only path forward to win the presidency and stop the dangerous candidacy of Donald Trump." While praising Sen. Bernie Sanders' campaign, Brown said "Clinton’s lead is insurmountable and Democrats have shown – by millions of votes – that they want her as their nominee. ... This is no time for Democrats to keep fighting each other. The general election has already begun."

Source:
GLASS CEILING STILL HARD TO CRACK
Clinton Says Voters Still Hung Up on Gender
7 hours ago
THE LATEST

In a New York Magazine profile, Hillary Clinton said she still encounters misogyny at her own events: “‘I really admire you, I really like you, I just don’t know if I can vote for a woman to be president.’ I mean, they come to my events and then they say that to me.”

Source:
CHANGE WE CAN’T BELIEVE IN
Trump Vows Not to Change
7 hours ago
THE LATEST
Source:
FILING DEADLINE IS JUNE 24
McConnell Urging Rubio to Run for Reelection
10 hours ago
THE LATEST

Senate Majority Leader Mitch McConnell: "One of the things that I’m hoping, I and my colleagues have been trying to convince Senator Marco Rubio to run again in Florida. He had indicated he was not going to, but we’re all hoping that he’ll reconsider, because poll data indicates that he is the one who can win for us. He would not only save a terrific senator for the Senate, but help save the majority. ... Well, I hope so. We’re all lobbying hard for him to run again."

Source:
×