Health and Human Services Secretary Kathleen Sebelius testified before a Senate committee Wednesday, telling lawmakers that while the troubled online marketplace for medical insurance isn’t entirely fixed, it is running more smoothly than it was after its launch a month ago. Sebelius received skeptical questions on the Affordable Care Act, known as Obamacare, from Sens. Orrin Hatch (R-Utah) and John Cornyn (R-Tex.), among others:
Sen. Pat Roberts of Kansas, who faces a tea party-backed challenger in 2014, was harsher still. “You have said the American people should hold you accountable, which is why today I repeat my request for you to resign.”
Sebelius, a former governor of the state Roberts represents, sat impassively as he spoke.
Despite the web site’s well-chronicled woes, Sebelius said it has improved dramatically since the administration launched its repair effort. Echoing testimony delivered on Monday by another administration official to a different committee, she said it is now able to process nearly 17,000 registrations an hour, with almost no errors. . . .
Republicans focused increasingly on issues of security, cost and coverage cancellations rather than the website, which Hatch said he assumed would be fixed.
Sebelius and Sen. Mike Crapo sparred after the Idaho Republican said many individuals will face far higher premiums next year when the program is in effect than they currently do.
The HHS secretary responded that the prices that insurance companies are charging are 16 percent lower than the Congressional Budget Office estimated. Crapo asked if she was saying prices would fall in 2014 compared to this year, and she conceded she was not. At the same time, she said that for the first time, the law will provide millions of Americans with government assistance in paying for insurance.
Obamacare has forced insurers to cancel some policies that do not meet the new law’s higher standards, and the cancellations have emboldened the law’s critics. But some of those policyholders are receiving subsidies and better coverage in exchange:
A week ago, Dianne Barrette was the poster child for the harms of health reform. Barrette is a 56-year-old Floridian who found she wouldn’t be able to keep her health insurance after Obamacare. . . .
Then The New Republic’s Jonathan Cohn called Barrette and walked through the subsidies she’d qualify for and the precise plans she might be able to get. Her response? “I would jump at it,” she told Cohn. “With my age, things can happen. I don’t want to have bills that could make me bankrupt. I don’t want to lose my house.”
“Maybe,” she said abut Obamacare, “it’s a blessing in disguise.”
In the space of about a week, in other words, Barrette went from Obamacare victim to Obamacare beneficiary.
Call this the fog of health reform: We’re in a period right now where the information coming out about the insurance people will get under Obamacare is often incomplete, wrong, or misleading.
The problems of the online insurance exchange are partly a result of the fact that many more states than expected did not build their own marketplaces:
In the lead up to October, it wasn’t clear that this extra workload would be a huge factor. There were arguments about whether the federal government’s work could be easily scaled. If you’re building one insurance marketplace, the thinking would go, its easy enough to plop that model down in any state where the feds are running the show.
In terms of the Web site’s consumer facing design, this worked: Each state on the federal marketplace uses the same homepage for HealthCare.gov. The application process looks the same, whether you’re buying coverage in Alaska or Wyoming.
But behind the scenes, the war room notes paint a completely different narrative, where each state’s idiosyncratic issues didn’t lend themselves to scale. Alaska and Wyoming, in other words, had totally different problems — ones that couldn’t be addressed with a singular fix.
Opinion writer Dana Milbank writes that President Obama made the mistake of working only with people he knew and trusted in implementing the law, rather than seeking the most qualified people:
Like his predecessor, he has rewarded loyalty and surrounded himself with like-minded advisers disinclined to dissent. This, combined with a Bush-like fetish for secrecy, has left the president in a bubble, struggling to find support in Congress or among the public.
That’s what makes the Iraq comparison resonate, even without Obama’s call for a technology “surge” to HealthCare.gov inviting the comparison. Although the policies are entirely different, both were unforced errors aggravated by a president’s insularity. Both men failed to hear warnings (about the intelligence and the military plan, in Bush’s case; about problems with the exchanges and the Web site, in Obama’s), overstated their cases (Bush’s hysteria about Iraq’s nuclear program; Obama’s keep-your-plan promise) and used the other side’s partisanship as an excuse to withhold information.
One of those who has made the Iraq comparison, National Journal’s Ron Fournier, argues that Obama “needs to do some soul-searching. What did I miss, and why? What was kept from me, and why?”
Bush didn’t ask those questions until his presidency was nearly over. Obama still has some time to cure the ills of insularity.
The administration has a stated goal of completing its work on the Web site by the end of this month.