Another city, another fundraiser. Again, “Hail to the Chief” played, and again, President Obama opened with his routine act: “It’s good to be back in San Francisco! Love this place!” He recognized the outstanding mayor and outstanding members of Congress and outstanding attorney general in attendance.
Then the president got introspective. “Sometimes people ask me, how do you keep up with everything involved in this job of yours, which is kind of a crazy job?” Obama said. “There’s a lot of stuff, and it’s all pretty complicated, and nobody is ever entirely happy with any decision that you make, and your hair is a lot grayer than it used to be.”
The president said his days start with great promise, but by the time they end, he looks at his to-do list and feels overwhelmed: “Man, we’ve still got a long way to go.”
“Kindness covers all of my political beliefs,” Obama told his audience of wealthy investors, high-tech donors, journalists and fellow Democrats Tuesday, only two months after he slashed at GOP legislators, calling them arsonists, nuclear blackmailers, economic wreckers, hostage-takers, obsessives and irresponsible extremists.
“When I think about what I’m fighting for, what gets me up every single day, [kindness] captures it just about as much as anything,” he told his audience at the DreamWorks studio in Glendale, Calif., which he visited as part of a seven-stop fundraising trip.
“Kindness; empathy — that sense that I have a stake in your success,” said Obama, who told supporters during the November election “Don’t boo. Vote. Voting is the best revenge.”
The website is a mess because the program is a mess. As Mom used to say, “What starts out twisted stays twisted.” The president oversold the benefits of the website just as he oversold how painless the entire law was going to be. He thought he could get away saying that if you liked your insurance you would be able to keep it. Why? Because he assumed the people who didn’t like their old plans would love their freshly minted Obamacare plans. Guess what, they don’t. Now he’s had to spin like mad—including making the estimates of coverage on the website look better than they are—and modify parts of the law by delaying the employer mandate and open enrollment next year. He faces a fundamental problem: The federal government can’t take on a project of this size. That’s why 56 percent of the public doesn’t agree with the underlying goal that every American should have health insurance, a record high.
Another nightmare is coming: People won’t be able to keep their doctor the way the president promised either. That’s because, in an effort to keep costs down, insurance companies are slashing doctor payments and limiting the number of doctors they will cover.
It’s called the Affordable Care Act, but according to, the Kaiser Family Foundation premiums in 2014 will likely be higher in most states. Even if they can get the website moving again, the law faces a slew of hurdles—the beleaguered IRS has to oversee the enforcement, next year those companies with more than 50 employees who were given a one-year reprieve from the mandate will be forced to join, and the system for paying insurers for “risk corridors” hasn’t been worked out. But this is about more than a health care law. This was the president’s signature legislative accomplishment. His team had three years to prepare, and even though many involved knew it was going to collapse on launch and tests just before the launch failed to handle 500 users, they went ahead anyway. Health care inflation may be down, but that’s because 77 percent of that cost decrease comes from the recession, not a law that was passed in 2010.
6) Once you’re able to get onto the website, you’ll have plenty of cheaper/better choices and be able to qualify for a subsidy.
No, you probably won’t. While the subsidies are generous for people on the lowest income end, many people – even low-income people – will be surprised to find how little the subsidy hides the aforementioned growth in premiums or how expensive the new plans are. And the rate shock they perceive for those premiums will likely be deceptive as well, as ProPublica notes here, because of the increases in deductibles and out-of-pocket co-pays associated with the new policies. Polling data thus far shows one of the major reasons people are coming to the website but not selecting a plan is because they’re surprised by the costs. For many people, $190 a month is absolutely affordable – but for those who weren’t buying insurance when it was $160 a month, they’re balking.
7) When people get covered under Obamacare, they’ll start liking the new system because they’ll get the same health care, but cheaper.
No, they probably won’t get what they expect. While I am amazed by how much the administration has bungled the rollout of the law, the real Achilles’ heel from my perspective has always been the second round of hits: the doc shock as people learn about the newly restricted networks under the plans offered via the exchanges. Many states have one insurer with dominant, near-monopoly market share, and in these states not having a critical hospital in the network can be a major problem for the ill. The best hospitals in the country – the Mayo Clinic, Cedars-Sinai, and other such household names – are typically also the most expensive hospitals in an insurer’s network. This means that the quickest way to be able to make a plan that is solvent under Obamacare’s regulatory model is to drop some of these expensive hospitals and systems from your plans. This is going to hit the sickest Americans hardest, as stories like this one show.
The technocratic idea is that you put a bunch of smart, competent people in government — folks who really want the thing to work — and they’ll make it happen. But “smart, competent people” are not a generic quantity; they’re incredibly domain-specific. Most academics couldn’t run a lemonade stand. Most successful entrepreneurs wouldn’t be able to muster the monomaniacal devotion needed to get a Ph.D. Neither group produces many folks who can consistently generate readable, engaging writing on a deadline. And none of us would be able to win a campaign for Congress.
Yet in my experience, the majority of people in these domains think that they could do everyone else’s job better, if they weren’t so busy with whatever it is they’re doing so well. It’s the illusion of omnicompetence, and in the case of HealthCare.gov, it seems to have been nearly fatal.
The policy people handed out impossible orders to the technical staff; when the technical staff couldn’t deliver their impossibility, they decided that the problem was incompetence. This percolated all the way down the line, and quite probably back up again — why bother explaining things if the people you’re doing the explaining to are idiots?
t the end of the day, the root of President Obama’s mendacity on Obamacare was simple: He didn’t dare tell people how the law would work. He couldn’t tell people how the law would work…
If this is the only way to pass your signature initiative—and a decades-long goal of your party—it ought to give you pause. But Obama was a natural at delivering sweeping and sincere-seeming assurances that weren’t true. This kind of thing is his métier.
If he were awoken at 3 a.m. and told he had to make the case for nationalizing the banks by denying he was nationalizing the banks, he would do an entirely creditable job of it, even without a TelePrompTer. The salesmanship for Obamacare represents in microcosm the larger Obama political project, which has always depended on throwing a reassuring skein of moderation on top of left-wing ideological aims.
The CNN results amplify Obama’s political problem: The Affordable Care Act imbroglio is having an outsized effect on his entire presidency, with voters reassessing his basic qualifications. “This is serious,” says Chris Kofinis, a Democratic strategist and former chief of staff to Sen. Joe Manchin of West Virginia. “This is much more serious than I hear some Democrats saying publicly. This is not a temporary drop.”
Adds John Geer, an expert on public opinion at Vanderbilt University, “In a sense, the public was collectively willing to be patient. That reservoir of support among independents and moderates has evaporated.”
For weeks, Democrats have hewn to the party line, arguing that once the website woes are repaired and people can enroll easily, the political climate will improve. And Kofinis is in that lot: “Fixing it will help turn it around. But not overnight. It’s a lot easier to fall—a lot harder to come back.”
— Barack Obama (@BarackObama) November 27, 2013
“I believe that health care reform will be the right thing for the country . . . It certainly wasn’t the smart ‘political’ thing! And I hope that in the months to come, you will keep an open mind and evaluate it based not on the political attacks but on what it does or doesn’t do to improve people’s lives. Sincerely, Barack Obama.”