Mikulski’s worries are profound and cut to the heart of the law’s unsteady implementation.

“What I worry about is that there’s such a crisis of confidence, people won’t enroll. And the very people we need to enroll, particularly our young people, to make this whole system work, won’t happen.”

A more devastating assessment of the law’s woes and the long-term consequences of the “fear” and “doubt” surrounding policy cancellations, a still-troubled website, and Obama’s own credibility gap could not have been uttered.

As anyone in politics will tell you, nothing wounds deeper in times of woe than truth told by a friend. It cuts in private. In public, it leaves a bleeding gash.

“The president shares Senator Mikulski’s frustration with the problems that we have seen,” White House press secretary Jay Carney said.

When I asked if Mikulski’s rhetoric was unduly alarmist, Carney said it was not. There you have it: White House confirmation that its signature legislative achievement now suffers from a crisis of confidence.