Fears that insurance exchanges that are the linchpin of President Barack Obama’s federal health care overhaul wouldn’t attract the young, healthy people needed to make them financially viable are being heightened by the early results of signups in several states

In California, the state with the largest uninsured population, most of those who applied were older people with health problems. In Kentucky, nearly 3 of 4 enrollees were over 35. In Washington state, about 23 percent of enrollees were between 18 and 34. And in Ohio, groups helping with enrollment described many of those coming to them as older residents who lost their jobs and health coverage during the recession…

In general, someone in his 60s uses $6 in health care services for every $1 tallied by someone in his 20s, said Nicole Kasabian Evans of the California Association of Health Plans. That makes younger adults a coveted group on industry balance sheets…

The potential for rising monthly premiums and higher policy deductibles is just one deterrent to convincing young people to sign up for coverage on the exchanges. The technological problems that have plagued the federal exchange, which is running in 36 states, and many state-run online marketplaces are slowing enrollment.

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The Obama administration will consider the new federal insurance marketplace a success if 80 percent of users can buy health-care plans online, according to government and industry officials familiar with the project.

The goal for how many people should be able to make it through the insurance exchange is an internal target that administration officials have not made public. It acknowledges that as many as one in five Americans who try to use the Web site to buy insurance will be unable to do so

According to a government official familiar with the new target, the 20 percent who are unlikely to be able to enroll online are expected to fall into three groups: people whose family circumstances are so complicated that the Web site cannot determine their eligibility for subsidies to help pay for health plans; people uncomfortable buying insurance on a computer; and people who encounter technical problems on the Web site.

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President Obama has a particular challenge. He is in a hunkered marathon of damage control. His signature achievement as president is in trouble, polls show Americans trust him less than they ever did, and he’s at that stage in his presidency where his legacy is beginning to be defined. Even the most pure-hearted pilgrim would have to lash himself to the mast to keep from engaging in spin to manage these problems. But when you spin in the middle of a credibility crisis, the garden-variety shadings required by the office can make your problem worse. That’s bad for the president’s standing and for his party, but it’s also bad because it means everything the president says gets a downgrade. If no one listens or believes you, it’s hard to make the case for any good news…

Credibility is not just about honesty. It’s about authority. Does the president really have command over the things he’s talking about? The president admitted that he was not in the loop about the colossal problems with his health care rollout…

Obama’s credibility challenges won’t stop when his incompetently mismanaged health care website is finally repaired. Once that gets fixed, the president will ride another credibility roller coaster: truthfully describing whether the Affordable Care Act is working as designed. All the attention on his law’s launch-pad disaster may have distracted people from the fact that the underlying pursuit is a very tough one. If healthcare.gov had launched perfectly, there still would have been a huge debate over whether Obamacare was working as promised. Were younger people signing up? Were the risk pools in various regions of the country filled with the right kinds of policyholders necessary to keep premiums in check? This was the original brain surgery the president was undertaking before the earthquake. Once the patient is lifted back off the floor and the generator is patched up, you still have to do brain surgery.

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For Democrats across the country, the reversal of political fortunes over the past month has been head-spinning. In mid-October, as Republicans were contending with voter fury over a 16-day government shutdown, Democrats had the momentum. In polls, a growing number of voters said they wanted the party to control Congress after next year’s election. Emboldened, a wave of strong recruits entered House contests. Democrats’ control of the Senate seemed secure. Money was flowing.

Then the problems with the Internet-based health exchanges came into focus, followed by millions of letters from insurance companies canceling individual policies that did not meet the health law’s minimum coverage requirements. Republicans found their voice. Democrats lost theirs. The polling gap closed, and Republican wallets opened. The National Republican Senatorial Committee raised $3.8 million in October, its best monthly showing of the year.

Representative Greg Walden of Oregon, chairman of the National Republican Congressional Committee, called it “a Category 5 political hurricane.”…

“If they continue to have weeks like the last two, sheesh,” State Senator Andy Sanborn, a Republican who is chairman of the Senate Commerce Committee, said over beers at his sports bar, the Draft. “I was having lunch with two of my Democratic friends, and holy guacamole — not the word they used — they are in a death spiral.”

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In Iowa, the disappointment in Obama and the health-care law’s rollout is deeper and more personally felt than in much of the rest of the country. That’s because, nearly six years ago, Iowans propelled Obama’s national career with his upset victory in the January 2008 presidential primary caucuses, setting the stage for beating Hillary Rodham Clinton for the Democratic nomination.

“It’s terrible, it’s painful to watch. We really do know him,” Dvorsky said. “Watching this is gut-wrenchingly painful.”

She said she thinks HealthCare.gov will be functioning well by the Nov. 30 deadline because that’s what the president said. “If I’m wrong, there’s going to be phenomenal pain.”

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Hubris has a way of ruining grand designs. And like reality, it bites.

So last week the Obama presidency began crumbling. Some may be disappointed, and may see him in heroic terms, withering like a character in an ancient tragedy…

Watching him blame others for the failure of his signature policy — saying, “I was not informed directly” — was depressing.

He’d promised us, repeatedly, famously, stridently, that under Obamacare, we could keep our health plans and our doctors. “Period,” he said.

He guaranteed it. He gave his word. It was as if he asked us to read his lips.

What he said wasn’t true. And Americans know it, and they don’t like it.

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Politicians who lie are hardly exotic. Chicanery is often merely the price of successful political salesmanship.

Incompetence, on the other hand, is far more damaging to the Democratic brand. Whereas the left and much of the narrative in the popular culture have already written Republicans off as impolitic and inept, liberals, on the other hand, assert their intellectual superiority and tout their “willingness to govern” and get things done as party mantra.

Not only is the left smarter and more sophisticated, they insist, they’re also supposed to prove that government can solve problems. More pointedly, that big, unwieldy bureaucracies like the Department of Health and Human Services and the IRS can solve massive problems, like healthcare.

Whether he was uninformed of or simply incurious about the potential failures, Obama’s lack of preparedness and competence in implementing his signature piece of legislation not only diminishes his credibility as a problem-solver, but it jeopardizes the faith in government that liberals rely on.

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[T]he White House’s cleverness had inevitable limits, which is why the law keeps facing backlash in fresh places, and why the media keep getting the chance to prepare Obamacare’ obituaries. And what’s going on right now, the convergence of the website’s technical problems with the backlash surrounding canceled plans, reveals the perils of trying to outsmart the political system’s status quo bias. Your strategy can end up so intricate and deceptive, and your policy so complex and jerry-built, that something as basic as a malfunctioning website can suffice to bring the whole policy crashing down.

The welfare state’s ability to defend itself against reform, however, carries a cautionary message for Obamacare’s critics as well. What isn’t killed outright grows stronger the longer it’s embedded in the federal apparatus, gaining constituents and interest-group support just by virtue of its existence even if it doesn’t work out the way it was designed. And as disastrous as its launch has been, if the health care law can survive this crisis in the same limping, staggering way it survived Scott Brown and the Supremes, then it will be a big step closer to being part of the status quo, with all the privileges and political strength that entails.

So yes — it’s possible that this brush with death will be fatal, possible that the law will fall with the lightest, most politically painless push. But it’s still likely that Obamacare will be undone only if its critics are willing to do something more painful, and take their own turn wrestling with a system that resists any kind of change.

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Via NRO.

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Via Campus Reform.

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