James Taranto found news of a hearing this week that I missed, in which Democratic lawmakers grilled Gary Cohen, head of the Center for Consumer Information and Insurance Oversight about Obamacare’s mounting problems. It’s like a David Brooks column about Obama, but in hearing form. Behold your moral and intellectual betters discover all the exact same things you’ve known for four years:
“Baucus questioned how well the online health insurance marketplaces would interact with what he called ‘archaic’ computer systems at Social Security and the Internal Revenue Service,” Kaiser reports.
Cohen also took hits from Sen. Maria Cantwell (D-Wash.), who criticized the administration for delaying implementation of the Basic Health Program — an option for states to provide cost-efficient health coverage outside of Medicaid and the law’s new insurance exchanges.
HHS has said it will not have the Basic Health Program ready until 2015 — a year behind schedule. State officials have balked, and Cantwell echoed their criticisms Thursday during the Senate Finance Committee hearing on the status of the implementation effort.
“We’re very concerned about the approach by the agency in trying to thwart this effort,” she said. “Are you artificially raising the cost to all taxpayers by trying to lure them onto the exchange?”
Cantwell warned that many members of the Finance Committee are familiar with state-based cost-control efforts and would not look kindly on HHS subverting them. She said the department has sidelined the Basic Health Plan in order to focus on the exchanges — which will provide subsidies from the federal government.
“What I’m very concerned about is the agency seems to think the technology of the exchange is the holy grail, and you’re trying to lure states” into the exchanges, she said.
Cohen said the Basic Health Plan has simply had to take a backseat to other priorities.
“I don’t think we’re trying to lure people into the exchange,” he said.
First of all, the agency could be forgiven for thinking “the technology of the exchange is the holy grail” and “trying to lure states” into exchanges since that’s nearly all the president, and the press has talked about in explaining the health care law. There are a couple reasons for that. It sounds like a relatively simple idea that people can relate to— a Travelocity for health care! No one mentions the challenges of making that “Travelocity” mechanism work with, yes, the archaic systems of the federal government, or aligning it with all state regulations and processes, or training state and federal employees to run exchanges and explain them to consumers, or that all of this has to be done before October. Exchanges, recently unsuccessfully rebranded as “marketplaces,” sound unobjectionable and have not yet had the chance to fail, as they don’t yet exist. As such, they’ve become a go-to selling point for the law. It’s only now that we’re creeping up on exchange deadlines, and the possibility of failure looms larger that the same people who’ve been pitching them are backing away from them.
Second, get used to the delay of certain parts of the health care bill. Attempting to remake 1/6 of the economy is not an easy task, and if it seemed to you in 2009 that the federal government, renowned for its efficiency, might be biting off more than it could chew, congratulations on your early demonstration of common sense. Unfortunately, it probably won’t buy you health insurance. Now Democratic senators are noticing the same thing, and have already voted to completely abandon parts of the health care bill its critics told them were unworkable before the law passed— the 1099 reporting requirement, the CLASS Act, and the medical device tax (repeal still in the works, but backed by none other than Sen. Elizabeth Warren (D-emonstrably Not Native American.))
“Wyden pressed Cohen to help find ways to resolve a glitch in the law which may result in the denial of federal assistance to millions of Americans of modest means who could be priced out of family health coverage at work,” according to Kaiser. At issue is an IRS ruling limiting federal subsidies for such plans. Said Wyden: “We’ve got millions of people–working-class, middle-class people–who are going to be pushed into a regulatory health coverage no man’s land.” So much for President Obama’s promise that if you like your plan, you can keep it.
Again, you entrusted the building of a massive Jenga tower of subsidies and regulations to the legislative equivalent of a keg party and you’re surprised it’s not coming together perfectly.
And, finally, Sen. Ben Nelson strongly objects to the elimination of one of Obamacare’s programs, as part of the 2012 tax deal. He voted for the tax deal:
If we’re going to hold people accountable, how about starting with Bill Nelson, who was among the 89 senators voting “yes” on the tax deal? Maybe that’s not entirely fair, since Nelson might have been unaware of that provision, and the expiration, less than two hours earlier, of the Bush tax cuts put genuine pressure on lawmakers to act quickly. Still, it’s odd for a member of Congress to be faulting the administration for a position it took in negotiating with Congress, rather than faulting himself and his colleagues for enacting a law whose provisions he doesn’t like.
Stay tuned. By the time we reach Jan. 1, 2014, those of us who didn’t get to keep our plan if we liked it can rely on Rep. Alan Grayson’s plan for health care: Don’t Get Sick.