Obama on Obamacare: Stuck between two narratives

Old and busted: Everyone will love Obamacare once it’s fully implemented.
New hotness: Obamacare is almost totally in place right now and all the fuss about implementation is much ado about nothing.

Up until recently, Obamacare implementation was supposed to be the big payoff. “Once it’s fully implemented,” lived like a mantra on the lips and pens of administration officials, talking heads, and op-ed writers, promising a time when the Affordable Care Act’s popularity would soar once its fruits were revealed. Jan. 1, 2014 was the moment we’d all been waiting for. Supporters swore any unmet expectations would be met that day. Faster rising premiums? Wait until 2014. Getting your hours cut? Wait until 2014. Like your insurance but unable to keep it? Just wait until you see what we’ve got for you in 2014.

Today, President Obama had news for all of us. The wait is over. The Affordable Care Act is virtually completely implemented, he said, and 90 percent of Americans are enjoying its fruits even if they don’t know it. Asked about concerns raised about implementation by ObamaCare author Sen. Max Baucus, Obama responded:

Well, I — you know, I think that any time you’re implementing something big, there is going to be people who are nervous and anxious about is it going to get done until it’s actually done.

But — but let’s just step back for a second and — and — and make sure the American people understand what it is that we’re doing. The Affordable Care Act, “Obamacare,” has now been with us for three years.

It’s gone through Supreme Court tests. It’s gone through efforts to repeal. A huge chunk of it’s already been implemented.

And for the 85 to 90 percent of Americans who already have health insurance, they’re already experiencing most of the benefits of the Affordable Care Act even if they don’t know it. Their insurance is more secure. Insurance companies can’t drop them for bad reasons. Their kids are able to stay on their health insurance until they’re 26 years old. They’re getting free preventive care.

So there are a whole host of benefits that — for the average American out there, for the 85 to 90 percent of Americans who already have health insurance, this thing’s already happened, and their only impact is that their insurance is stronger, better, more secure than it was before. Full stop. That’s it. Now they don’t have to worry about anything else.

The American people could be forgiven for being underwhelmed. He’s right about the few popular parts of the bill he always cites— protection for those with preexisting conditions, coverage of adult children until age 26 on parents’ plans, etc.—though notably those elements haven’t raised the bill over 50 percent approval in three years.

But Obama promised average annual premium reductions of $2,500 per family once Obamacare passed. He promised no interruptions in your current coverage if you were satisfied with it. He promised to bend the cost curve down for government spending on health care while adding millions to Medicaid’s rolls. And, he promised to do it all without adding to the deficit. None of those things are true, yet he claims the master plan is 90 percent complete.

The president’s answer goes on to dismiss the very real pain and dissatisfaction Americans are feeling with their health insurance in the age of Obamacare. The strategy of his supporters is to blame any problems in the current system or impending problems on various for-profit companies trying to collect their pound of flesh before Obamacare is fully implemented. But now that implementation is a problem, and the president has already given up that argument, he instead pretends no problems exist—that the status quo is not only acceptable, but has met his goals.

This is an unwise strategy for a couple reasons. It sounds quite flippant to families dealing with the possibility or reality of colossal rate hikes that all their problems have already been solved, even if they don’t know it. To them, it’s demonstrably untrue, no matter what force they blame for it. To have the man who promised $2,500 rate cuts to push a rather unpopular bill for two years say the current situation is the fruition of his promise is the clearest barometer of how low expectations have fallen.

Two, the president dismissed the idea of fallout for people who have insurance now, despite many forecasts, red flags, and business protestations to the contrary. As New York Times Congressional reporter Jonathan Weisman tweeted during the press conference, this ride is not over for them. “Whoa, Obama claim that folks who have insurance now have already gone through the ACA implementation is just not rt. Lots of issues left.”

Phil Klein outlines just a few:

In reality, new taxes kick in next year along with the individual mandate, changes to Medicare, fines on businesses that do not offer health insurance, new insurance regulations that will drive up the cost of premiums, along with myriad other provisions with wide-ranging impact. And this assumes that the new insurance exchanges will be open for business in October and ready to deliver benefits in January, as scheduled.

I expected the president to blame current and future problems with the health care system on anything other than his overhaul. I didn’t expect him to pretend they don’t exist. The president even concedes in the same answer “even if we do everything perfectly, there’ll still be, you know, glitches and bumps, and there’ll be stories that can be written that says, oh, look, this thing’s, you know, not working the way it’s supposed to, and this happened and that happened. And that’s pretty much true of every government program that’s ever been set up.”

He’s already spent the last five years raising expectations impossibly high for this piece of legislation, which will be inextricably linked to his presidency forever. Now, as even its supporters concede this car’s probably going to get in the dirt, might be a good time to tap the brakes. But the president went the other direction, claiming no one but the 15 percent of uninsured have anything to worry about during implementation.

And, let’s talk about the 15 percent— that “small group of people” for whom he concedes implementation will be a problem. When we began the process of debating and passing Obamacare, some 80+ percent of insured Americans were satisfied with their health insurance coverage. The president insisted we disrupt much of the entire system to serve exactly the “small group of people” he now admits without any apology will be hardest hit by implementation. Again, the president who was elected in no small part because he “understands people like me” cavalierly dismisses the real pain his policies might impose on this “relatively narrow group.” I doubt the smallness of the group is any comfort to those in it, many of whom are young, healthy Americans who will suffer huge rate increases because of Obamacare or pay the tax man if they don’t acquiesce to their huge rate increases. Their concerns are more than mere “hue and cry” or “sky is falling” fears, as the president dismissively terms them. They used to be his principal reason for passing a giant piece of health care legislation. My, how times have changed.

For three years, we’ve been hearing Obamacare is a promise whose glories were merely deferred until “full implementation.” Now that full implementation is a problem, we’re told this was the promise all along.