So two weeks in, here’s where we’re at: Many and perhaps most users can’t even get into the federal exchange system. Those who can are often stymied by errors, and can’t trust that any subsidized insurance prices they see will be accurate. And then, even if they do manage to get all the way through the system, their applications may not transmit properly to the insurers from whom they are trying to purchase insurance. In short, nothing works. It’s a failure at every level…
In order for coverage to start on January 1, individuals will have to complete applications by December 15. And in order to avoid the law’s penalty for remaining uninsured, they’ll have to be enrolled by February 15 of next year—not the end of March.
In other words, the administration doesn’t really have six months to fix problems with the exchanges. Political pressure will build well before the end of March. If there isn’t significant progress in a fairly short period of time, I suspect we’ll start to see a lot more supporters begin to question the law, or at least start to wonder aloud about what to do with a health care overhaul that simply doesn’t work.
In the months before the launch almost every senior member of the Obama administration had a little calendar board tacked up in a prominent spot in their office. “75 days until Obamacare” it would say. The next morning they would tear off the page. “74 days until Obamacare” it would say. The message — to them and to their visitors — was clear: This was the White House’s top priority.
We’re now negative 14 days until the Affordable Care Act and most people still can’t purchase insurance. The magnitude of this failure is stunning. Yes, the federal health-care law is a complicated project, government IT rules are a mess, and the scrutiny has been overwhelming. But the Obama administration knew all that going in. They should’ve been able to build an online portal that works.
Early on, President Obama like to compare the launch of the Affordable Care Act to Apple launching a new product. Can you imagine how many people Steve Jobs would’ve fired by now if he’d launched a new product like this?
Is there someone in the federal government who will be held accountable for the fact that many Americans are still encountering problems as they seek to sign up for insurance on the federal exchange?
Administration officials, who could not be reached immediately for comment, have not identified which officials at Health and Human Services were directly in charge of the new computer enrollment system, or which companies are most involved with fixing it now. Both GCI Federal and Quality Software Services Inc. helped construct the Web site and data hub, respectively…
“Despite our warnings that the law was not ready for prime time, the administration repeatedly brushed us off, proclaiming everything was ‘on track,” said House Energy and Commerce Committee Chairman Fred Upton in a statement Monday. “The first two weeks of enrollment have been a nightmare, and we now know despite over three years to prepare, the administration was in over its head. After hundreds of millions of dollars spent on a shoddy website and numerous broken promises, the American people deserve answers, and we are going to get to the bottom of this mess in the coming weeks.”
“Healthcare.gov was initially going to include an option to browse before registering,” report Christopher Weaver and Louise Radnofsky in the Wall Street Journal. “But that tool was delayed, people familiar with the situation said.” Why was it delayed? “An HHS spokeswoman said the agency wanted to ensure that users were aware of their eligibility for subsidies that could help pay for coverage, before they started seeing the prices of policies.” (Emphasis added.)…
The answer is that Obamacare wasn’t designed to help healthy people with average incomes get health insurance. It was designed to force those people to pay more for coverage, in order to subsidize insurance for people with incomes near the poverty line, and those with chronic or costly medical conditions.
But the laws’ supporters and enforcers don’t want you to know that, because it would violate the President’s incessantly repeated promise that nothing would change for the people that Obamacare doesn’t directly help. If you shop for Obamacare-based coverage without knowing if you qualify for subsidies, you might be discouraged by the law’s steep costs…
This political objective—masking the true underlying cost of Obamacare’s insurance plans—far outweighed the operational objective of making the federal website work properly. Think about it the other way around. If the “Affordable Care Act” truly did make health insurance more affordable, there would be no need to hide these prices from the public.
The functional failures of the Affordable Care Act websites are well-documented, but the fundamental flaw is the law’s mind-numbing complexity. The officials who planned ObamaCare blame their Web engineers, but they’re passing the buck. ObamaCare is a hugely complicated approach to addressing problems in health care that have simpler solutions.
Software glitches are no surprise with such a complex system. For example, signing up uses a Byzantine process to check if a family is entitled to a subsidy, requiring data from dozens of federal and state agencies using databases built on different technology platforms…
These include Medicaid to determine eligibility, the Internal Revenue Service to determine insurance-premium subsidies based on income, and Homeland Security to confirm citizenship. To make sure the family isn’t covered elsewhere, the sites have to retrieve data from the Veterans Health Administration, the Office of Personnel Management and state Medicaid and Children’s Health Insurance Programs. Assuming a family is cleared and purchases a plan, the information has to be handed off cleanly to an insurance company.
The Government Accountability Office last year calculated that for the IRS alone, implementing ObamaCare would be a “massive undertaking that involves 47 different statutory provisions and extensive coordination.”
“I think we have missed a big issue. I don’t think there’s any question that this whole shutdown episode has covered for the bad rollout of ObamaCare,” said Rep. Tom Cole (R-Okla.), an ally of Speaker John Boehner (R-Ohio). “A lot of us warned that.”…
In many ways, this was the “train wreck” that Senate Finance Chairman Max Baucus (D-Mont.) was actually talking about — a botched implementation that obscured the law’s coverage options.
But Obama didn’t receive a single question about the snafus at a news conference last week, despite an appearance before reporters that lasted more than an hour…
“I think we can fight the problems with ObamaCare in a more intelligent way than we have, and actually get some success out of it,” Rep. Charles Boustany (R-La.), another leadership ally, told reporters. “But we are where we are.”
Back in the first week of the month, I was in Philadelphia and someone asked me if the reason HealthCare.gov wasn’t working was that the people running the site were furloughed because of the shutdown. I explained that no that isn’t the case and these are just two unrelated things that happened the same week in politics. Then in Cleveland last week a cab driver who found I was coming from DC explained to me how outrageous he thought it was that Republicans had shut down the websites that would have let him sign up for health insurance. And a bartender told me the GOP is getting what it wants out of the shutdown—Obamacare isn’t launching.
Which is to say that I think a large share of people don’t realize that this problems with the Affordable Care Act IT infrastructure have very little to do with Republicans and basically nothing to do with the shutdown.
After all, it’s confusing. Republicans did shut the government down. They did shut the government down in order to stop Obamacare. The shutdown came on the same week that Obamacare’s websites were supposed to launch. And for many people, the websites are not in fact working. So it’s natural—but wrong—to think that the non-functionality of the websites is the shutdown. It seems to be the case that many grassroots conservatives believed, pre-shutdown, that the Ted Cruz strategy could actually prevent Obamacare from launching. And now it seems to be the case that many grassroots liberals believe, in the wake of the botched website launch, that it’s Ted Cruz rather than IT contractors and their overseers in the administration who’ve screwed things up.
Once the administration figures out its technical issues, as it presumably will, Obamacare will move into the sticker-shock phase, as millions of Americans discover they will pay higher premiums, or higher deductibles, or both, for the same type of insurance they had before Obamacare. The Republican campaign would go all-out to inform Americans that that is on the way. And at every step, the GOP would play Obama’s promise: If you like your health coverage, you can keep it…
But it didn’t happen. The GOP chose instead to embark on its ill-fated drive to defund Obamacare. When that failed, Republicans made progressively weaker demands that the White House delay or somehow limit Obamacare, and those failed, too. In the meantime, the Republican effort has led to a partial shutdown of the government, now nearly two weeks old. And the shutdown battle has morphed into a fight over the debt limit and the possibility the nation will default on its debts next Thursday…
Instead of pounding Obama on the mandates, defects, false promises, and expense of Obamacare, Republicans ended up pounding themselves.
Of course the GOP will have more chances to fight Obamacare in the future. Long after a continuing resolution has been passed and the debt limit raised, Obamacare will still be a major, and for many unwelcome, factor in American life. But what an opportunity missed, at such a crucial time.
Via RCP.
Via the Daily Rushbo.
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