It’s been called a “train wreck” by its author, Democratic Senator Max Baucus, and an unpublished report from the Congressional Research Service demonstrates why. Forbes’ Avik Roy discovers that the Obama administration has missed at least half of its statutory deadlines for ObamaCare already, and only a small minority of those have anything to do with Congressional appropriations:
The new CRS memo, dated June 5, 2013, is an addendum to a series of previous reports in which the agency examined missed deadlines during the law’s first two years. The CRS excluded from its analysis deadlines that don’t reflect on the administration’s competence; for example, as states expand Medicaid, the federal spending associated with those expansions occurs more or less automatically. Deadlines that the law imposes on non-federal government actors, like state governments and private companies, were also excluded.
As of May 31, 2013, when the CRS analysis was completed, the White House had yet to meet 9 of 12 deadlines from the first year after the Affordable Care Act was enacted. It failed to meet 22 of 53 deadlines in the second year; another 8 became moot after Congress did not appropriate funds to complete the assigned tasks. In year three, the administration missed 10 out of 17 deadlines. That’s a total of 41 out of 82 deadlines missed.
If you exclude the 9 deadlines that became moot because Congress never appropriated the funds to meet them, the Obama administration missed 41 out of 73 deadlines, or 56 percent.
In analyzing the CRS report, I erred on the side of generosity. If the administration missed a particular statutory deadline by a week or less, I counted it in their favor as a “met” deadline. In any case where there was ambiguity in the CRS report, I assumed that the administration had met the deadline. So these 50-56 percent missed deadline figures should be seen as slightly conservative.
Roy charted the data:
This puts paid to the myth pushed by the White House and its apologists that the “train wreck” is a result of Republican sabotage of ObamaCare. Only that small subset of deadlines got missed for lack of funding. Nearly three times as many were missed despite the funding necessary, and almost double again were missed but eventually completed. If the only deadlines missed were those involving a lack of appropriations, then ObamaCare would be a raging success instead of the wheels-off “train wreck” that it is.
For instance, one of the big selling features of ObamaCare was that the law would force providers to work toward health outcomes rather than the traditional fee-for-service model that exists in … well, every service market, including health care. HHS was supposed to have built reporting models for private insurers to track progress to that goal “to improve health outcomes, prevent hospital readmission, ensure patient safety and reduce medical errors, and implement wellness and health promotion activities.” It also required Kathleen Sebelius “to promulgate regulations that provide criteria for determining reimbursement structure to improve quality,” in order to complete that transformation.
That was due on March 23, 2012, eighteen months ago this week. So far, HHS hasn’t uttered or written one word about this statutory deadline, which means that insurers have no idea how HHS wants them to go about achieving the outcome-based reimbursement model. It’s not even clear if HHS has any idea at all how to achieve that goal. In fact, it can be assumed at this point, 42 months after ObamaCare passed Congress, that the White House has no idea how to fulfill that pledge.
With this much failure and ambiguity, there is no value at all in proceeding with ObamaCare, especially as its perverse incentives remakes the labor market for the worse. It’s time to call a halt to the train wreck before it takes out the whole system.