The arbiter is President Obama and a phalanx of health care advisers and political strategists.

Together, they try to implement what even Obama’s heartiest loyalists concede is an onerous and complicated law. They do this amid myriad Democratic midterm anxieties. And frothy Republican objections.

But it’s time to concede that no one has been more adept or aggressive about delaying and defanging Obamacare than Obama himself. Systematically and with an eye toward his party’s immediate political troubles, Obama has reshaped, photo-shopped, reimagined, and reengineered Obamacare. It all sounds techy and cool and flexible—at least to the administration. To those who must live with and live under the law, the arbitrary is the norm. The only pattern is chaos. Obamacare’s worst enemy is Obama.