Much of the debate about the Obamacare rollout has centered on whether or not its early troubles will turn people off the idea that government can do big things well. But people do not turn to government programs because they believe in them. They turn to them because they need them, and the market is not meeting their needs. When your alternative is not something excellent but nothing, you use whatever is there. A bad lunch is still lunch, an overrun city college is still a pathway to prosperity, and Medicaid is far better than six months of calls from debt collectors.
That’s going to save the Obamacare rollout. It’s also going to make many people who don’t normally deal with government programs for people in need feel uncomfortable as they encounter a level of bureaucratic inefficiency they are unused to. There are two main constituencies for Obamacare: people who don’t have insurance, and people who have insurance in the private market already. Both are being funneled into Healthcare.gov, the woe-begone federally-run site for health-insurance marketplaces in 36 states. As Jeff Young at the Huffington Post pointed out this morning, a number of individual-market plans are shutting down now that they must meet higher standards, making it urgent for individual-market buyers to transfer to a new plan through Healthcare.gov or one of the state exchanges before the start of the new year. Meanwhile, the “Obamacare enrollment website remains badly broken despite two weeks of intensive round-the-clock efforts at repairs,” according to Politico.
People who have experience with programs for the needy will recognize a familiar bureaucratic incompetence in the rollout. It’s a tragedy to watch early efforts to sign up through a new government-mandated insurance access route—as by these working-class Floridians—turn into one more sad chapter in a long book called the humiliations and frustrations of not being well-off in America.
Yet the fact remains that there are uninsured who need health insurance, and they will need it whether or not it is easy to get.