Last week, President Barack Obama gathered some of his top advisers in the Oval Office to discuss the problem-plagued rollout of his health care legislation. He told his team the administration had to own up to the fact that there were no excuses for not having the health care website ready to operate on Day One…
Administration officials say more than 476,000 health insurance applications have been filed through federal and state exchanges. The figures mark the most detailed measure yet of the problem-plagued rollout of the insurance market place.
However, the officials continue to refuse to say how many people have actually enrolled in the insurance markets.
Senator Marco Rubio (R., Fla.) wouldn’t call for Health and Human Services secretary Kathleen Sebelius’ resignation at this juncture, but he indicated he may do so later on.
“I think that may become an option,” Rubio said on Fox News Sunday today. “I’m not a big fan of media calls for people to resign, but I think in this case, actions like the one you just outlined are going make it harder and harder for her to do her job effectively.”…
“Her refusal to testify and be transparent about it, I think, is undermining her credibility,” he said. “And there may come a point now, perhaps we’re not there today … where she will have to resign, largely because she no longer has the credibility to do the job.”
[T]he fact that the White House is having trouble implementing Obamacare also should not come as a particular surprise. It is not that the Obama administration is especially incompetent. Rather, the program it is charged with executing is a complex public-private hybrid that has no real precedent elsewhere in the world. The blend is purely American: Policymakers in the United States have a history of jerry-rigging complicated programs of this sort precisely because they have little faith in government. The result is a self-fulfilling prophecy that fuels only deeper public cynicism about the welfare state…
The real source of Obamacare’s current problems lies in the law’s complexity. A straightforward way to assure coverage would have been to extend an existing, well-worn program to more people. This is how most other countries guarantee health insurance. In the British National Health Service, there is little that beneficiaries need to do in order to receive health insurance, as all residents are automatically entitled…
The larger irony here is that administering a complex public-private health-care system often requires more government, not less. Yet the very same impulse that created this system also impairs the government agencies that could effectively oversee it.
The “most transparent administration in history” has been aggressively silent about HealthCare.gov’s debacle. CGI Global just flat out won’t talk to the press. Kathleen Sebelius, secretary of health and human services, did a widely panned interview with Jon Stewart, where she made the claim that excess demand is crushing the system…
Now, there are all sorts of well-intentioned reasons why the administration would behave in a closed, paranoid fashion. Republicans are circling like vultures for any weakness that could legitimize a delay or reversal of the Affordable Care Act. So the administration sweeps problems under a rug, in the hopes that they can sort out the mess later.
But these tactics are telling about the true values of the White House. When push comes to shove, it does not see democracy as a solution to problems. It does not trust citizens, it does not trust the press, and it definitely doesn’t trust the entrepreneurial spirit of small business.
Like a paranoid ruler, it only trusts what it can directly control. HealthCare.gov could have been a shining example of how an open exchange of ideas makes America a better place, setting precedent for a more innovative government generations to come. That was Obama’s big promise about the change he would bring to Washington. Now, our healthcare system is as broken as Obama’s promise.
The penalty for being uninsured next year is $95. Again, this is partly true. In fact, the penalty for being uninsured next year is $95 or 1 percent of your income, whichever is higher. So if you make $75,000 a year and you decide to go without insurance, the penalty will be $750. There are a number of things you can do to avoid having to pay it, from deliberately getting your utilities shut off to under-withholding taxes from your paycheck so that they don’t have a refund from which to take out the penalty. But that number is what will go on the books at the Internal Revenue Service, not the $95 you’ve probably heard.
If the exchanges don’t work, as a last resort, we can always get people signed up through call centers. It’s true, there are call centers. But the computer systems at the call centers for states running the insurance exchanges are the same as the computer systems that consumers are having such a hard time with. A nice woman at a federal call center told me that (at least for the state of Florida, where my in-laws live) there is an alternate procedure: They can fill out a manual application in PDF format. But she also told me that it takes three weeks for that application to be mailed to your house. After you receive it, you check the application to ensure it’s accurate, and then mail it in. One to two weeks later, you will be notified of your subsidy eligibility. Then you can actually enroll in a plan, though she wasn’t quite clear on how that part would work — do you call back again?
This may work for older people who simply can’t figure out how to use computers, or for desperately ill people who have been rebuffed by the computer system . . . but so will repeatedly logging in until you finally get the system to work. It is unlikely to get loads of healthy, young, premium-paying folks to sign up for insurance and thereby make this whole thing financially viable. And by the time we’re ready to default to this option, it’s unlikely that there will be enough time to make it work.
During an interview for “This Week,” former Republican Florida Gov. Jeb Bush encouraged Texas Republican Sen. Ted Cruz – who told ABC News that he would do “anything” to stop Obamacare – to come up with an alternative and show some restraint if his aim was to repeal the president’s signature healthcare law.
“I think the best way to repeal Obamacare is to have an alternative; we never hear the alternative…we could do this in a much lower cost with improved quality based on our principles, free market principles…and two, show how Obamacare, flawed to its core, doesn’t work,” Bush said.
“So have a little bit of self-restraint. It might actually be a politically — a better approach to see the massive dysfunction,” he said, after being asked by ABC’s Jonathan Karl what his message would be for Cruz, who is still keen on repealing Obamacare.
If this happens, there will be a lot of schadenfreude on the right at the spectacle of technocratic failure. But the wreck of the exchanges may actually be worse for conservative policy objectives than a more successful rollout would have been.
That’s because while conservatives think the Obamacare exchanges are overregulated and oversubsidized, they are actually closer to the right-of-center vision for health care reform than the Obamacare Medicaid expansion, which is happening no matter what transpires with Healthcare.gov. So if the exchanges fail and the Medicaid expansion takes effect (and, inevitably, becomes difficult to roll back), we’ll be left with an individual market that’s completely dysfunctional and a more socialized system over all.
In that scenario, the Democratic Party would probably end up pushing, not for the pipe dream of true single payer, but for a further bottom-up/top-down socialization, in which Medicare is offered to 55- to 65-year-olds and Medicaid is eventually expanded even more.
Meanwhile, the task for serious conservative reformers — already not the most politically effective bunch — might actually become harder, because they would have to explain how their plan to build an effective, exchange-based marketplace differed from the Obama White House’s exchange fiasco.