Vice President Joe Biden expressed confidence Monday that the administration is going to fix the embattled federal healthcare website.
“The truth is, we’re going to fix it,” Biden said at Ellington Field airport in Houston, speaking to volunteers working to help people enroll in health insurance under the Affordable Care Act.
“God willing,” he added later.
Busted website, canceled policies, lousy early enrollment numbers. And that could be just the warmup.
Because the lesson of the last six weeks is that when it comes to the Obamacare rollout, if it can go wrong, it probably will.
The stumble-filled debut of President Barack Obama’s health care law is drawing new attention to the other risks that have been on the radar screen of health care wonks for months. Think health insurance plans sinking under the weight of sick customers, newly insured people being stunned that they still have to spend on health care, and possibly another wave of canceled policies — right before the 2014 elections.
They’re mostly worst-case scenarios, and an Obamacare recovery in the next few months could still prevent some of the biggest ones from ever happening. But health care experts are taking all of them a lot more seriously now — because at this point, why wouldn’t they?
The Obama administration is lowering the bar again on the problem-plagued ObamaCare website, saying that it will be “greatly improved” by month’s end — not fixed.
“The consumer experience … will be greatly improved for the vast majority of users by November 30,” Henry Chao, the Centers for Medicare and Medicaid Services’ deputy chief information officer, will tell House investigators on Tuesday, according to written testimony obtained by Fox News.
Chao’s testimony, 11 days before the fix deadline, appears to be the most recent case of the administration attempting to lower expectations, or at least prepare Americans for more problems when attempting to enter the site to purchase insurance policies that begin coverage January 1.
1. The Washington Post reported on Sunday that the Obama administration will consider the new online marketplace a success if 80 percent of users can buy health insurance. That is absurd. First, it’s another broken promise. The president and his advisers responded to the disastrous rollout last month by vowing to deliver an Amazon.com-quality website by the end of November. (If history remembers President Obama for one thing, other than his barrier-breaking 2008 election, it might be the outsized and unmet expectations that paved the path of his presidency.) Second, in what other line of work is 20 percent failure considered a success? If one out of every five meals served by a restaurant is inedible, the joint goes out of business.
2. The same story by Amy Goldstein and Juliet Eilperin revealed that the Health and Human Services Department hired technology contractors without requiring specific performance criteria. It is customary in the private sector to include benchmarks in technology contracts. Not so with the seat-of-their-smarty-pants Obama administration. “The meaning of success was defined for the first time during the panicky days of October, when White House officials belatedly recognized that the federal exchange had serious software and hardware defects,” The Post reported.
3. Incompetence is one thing. Secrecy is another. The administration that promised to be the most transparent ever settled on the “80-percent-is-better-than-nothing” construction without making it public. The Post story is based on unidentified sources. The president suggested for the first time last week that the site would not be perfect, but he did not go into detail. He should.
It gets worse. As the American Enterprise Institute’s Dr. Scott Gottlieb has pointed out, there is already a second wave of cancellations set to come right before the 2014 mid-term elections. It turns out that many small businesses with fewer than 50 employees, who buy in the small-group market, were able to exploit a loophole in Obamacare and avoid for one year the mandates being placed on plans in the individual market. Those businesses get to keep offering coverage that does not meet Obamacare requirements until the end of 2014. But, Gottlieb writes, that means that “starting in October 2014, many employees of small businesses will start getting the same notices that are now being mailed to individuals, informing that their existing health plans are also being cancelled.”
In other words, right before Election Day 2014, people in the small-group market are scheduled to lose their plans. If the fix Obama announced last week succeeds, then many more in the individual market will also lose their plans at the very same time — and Democrats could lose control of the Senate…
So even if the Web site does work a year from now, it won’t matter because Obamacare will be unaffordable. Those losing their plans right before Election Day will be in the same bind they are in today. Except there will be potentially millions more of them than there are today.
Even in the face of rough public opinion, the mantra of Congressional Democrats has been to fix the health care law, not cater to Republican extremism to repeal it. But after the president’s press conference last week, there’s been a palpable pessimism in Democratic strategists’ thinking. When I asked one Democratic campaign operative why blue-state Senate candidates like Peters and Braley would support a bill that the White House said would gut Obamacare, the answer was: “We’re on our own. We don’t care what the White House says. Would you trust them?”
That’s the type of thinking that could endanger a health care law that seemed untouchable several months ago. If the administration can’t fix the myriad problems ailing the health care exchange website, and more sob stories emerge about people losing or paying significantly more for their insurance, it’s an unsustainable formula for Democrats. There’s not much time left on the election clock to turn things around. They’ve shown unfailing loyalty to the president, but unless he manages an unlikely fourth quarter comeback, those bonds could break — and the results could get ugly.
An engaged chief executive would have been demanding frequent and detailed progress reports from his team. He would have gotten early warnings about possible glitches. But this president is tragically and inexcusably hands-off…
At the time the law was passed, administration leaders and many commentators compared the Affordable Care Act to Social Security and Medicare. The analogy was never apt. These great achievements are public public programs, efficient to administer and testament to the fact that government can serve social objectives far more effectively than the private sector.
Obamacare, by contrast, is the inefficiency of “public-private partnerships” at its worst. It is a public subsidy for the private insurance industry. No fewer than 55 separate contractors were hired to design the software. Yet though it is not a true public program worthy of the name, Obamacare is being used to discredit government.
Taking the long view, it looks increasingly as if 2008 was a missed historical moment.
Emboldened conservatives and worried liberals alike agree that the future of the Democratic Party’s plausible agenda, and of liberalism itself, is on the line.
Obama’s challenge is now nothing less than to assure that the cycle of progressivism he presumed to usher in, and the period of renewed faith and confidence in the transformative powers of government that he promised, does not die aborning. That will be no easy task.
“Unlike the Republican agenda, the Democratic agenda does not work unless people have a certain level of trust in the competence of the government to act on their behalf,” said William Galston, a senior fellow at the Brookings Institution, who 25 years ago helped launch the centrist “New Democratic” agenda that brought the Democrats back from years in the presidential wilderness. “That is, if you will, the Democratic proposition. It’s not to say that the government should do everything, but it is to say there’s an indispensable — and not necessarily small — role for government at every level.”…
“Case studies are going to be written about this for years to come,” said David Gergen, director of the Center for Public Leadership at Harvard’s Kennedy School and a bipartisan veteran of three White House staffs. “I’m not sure people are ever going to be able to totally unravel this story — it beggars belief.”
It turns out if you sell a health care plan on the basis that we won’t increase the debt and nobody will be a loser, then, when there are losers, they get really mad. And there were bound to be losers. And so that’s part of it.
But part of it is just the weakening of the law, the weakening of support for the law, and the weakening of the own president’s authority to say, trust me, trust me. I’m really struck by the downward slide that he’s doing.
I’m a little surprised by it, frankly. And what’s interesting is, compared to Reagan and Clinton in their second terms, had very similar popular approval ratings, which were going up at this point. George W. Bush and Barack Obama have extremely similar downward slopes. Bush’s went all the way through, caused by Iraq and Katrina, and, in Obama’s case, health care and other things.
And one of the things that strikes me is the country has changed, much more cynical, much more anti-Washington and, as a result of that, much less likely to come in a big collective effort to help some uninsured off, so much more skeptical of the law, and, second, when it is not implemented properly, much more punishing on the government. And so that makes it very fragile to me.
It is bad enough that self-employed and individually insured Americans are being dictated to from a faraway city. After all, there is neither a moral nor legal provision in the United States Constitution that allows the executive to decide what free men should choose to buy. And yet it gets worse when one acknowledges that the services that the government wishes to foist upon the individual market are generally inferior. “President Obama will soon become the country’s biggest purveyor of second-rate coverage,” doctor and former FDA official Scott Gottlieb (no relation to Lori) wrote in the New York Post. “Many of the policies sold in the exchanges are ‘narrow network’ plans with very limited choice of doctors.” Hard workers could be forgiven for looking at their efforts and wondering, “Why bother?”
One of the things that has distinguished America from the social democracies of Europe is that its safety net was just that: a net into which one might fall but in which one would not be enveloped. In Europe, one is pushed into interaction with the government as a matter of course — and even encouraged to engage. In America, there was traditionally help if you really needed it, but you had to be old or poor or disabled first. Obamacare changes that, interfering in the lives of the millions of Americans who had no intention of getting involved with the state and saying breezily to the self-sustaining middle class that there is no escape from the insidious meddling of a corpulent Uncle Sam — even if they do work hard and play by the rules every day.
“What I’m hearing from the White House is: There will be changes to the president’s team coming out of this, but they are not looking to fire anyone now.”