Declaring all is well with Obamacare is akin, these days, to saying the GOP won the shutdown fight. Both are nonsense. How do we know things are going so badly?
For starters, the argument is now about how extensive the problems are. The White House says it is just a few computer problems while critics say the problem is much bigger. House Majority Leader Eric Cantor (R-Va.) put out a statement after the president’s Rose Garden appearance Monday, “The Rose Garden isn’t big enough to fit the millions of American families receiving letters in the mail that the health insurance they like is being cancelled or that their premiums and out-of-pocket expenses are going up yet again.” He continued on:
ObamaCare’s problem is larger than a website failure, and it will take more than a ‘tech surge’ to fix it. The website does serve as stark evidence that the federal government is ill-equipped to centrally manage our nation’s health care.
The President should immediately instruct HHS Secretary Kathleen Sebelius to
testify in front of Congress this week on the status of the health care exchanges.
The President should give his support to the bipartisan legislation in the
House of Representatives to provide the same break for working middle class
Americans that he has already provided for big business and delay the
individual mandate for one year. When you are unable to even access the
ObamaCare website, waiving the penalty for signing up should not be
That’s the logical and restrained argument from which the GOP was temporarily diverted during the shutdown fiasco.
This is not merely a conservative media story, which the major newspapers and TV and cable networks can ignore. It is front-page news in the mainstream media. Even MSNBC is getting into the act. The New York Times makes clear that the problems, even if limited to computer issues, will take weeks to fix.
Unlike Benghazi or the Internal Revenue Service scandals, senior officials can’t possibly claim they were unaware of the problems. As a result, Republicans are calling for Sebelius to be fired, which might in fact be a good idea for the White House. In order to maintain their claim that Obamacare is doable, they must make the case that it was just the particulars of this launch that are problematic. One way to do that is to fire the woman in charge of it. If the problems are just too big and complex to lay at her feet, then maybe a statutory scheme this big and complex can’t work.
Moreover, as the previously Obamacare-friendly Wonkblog explains, it is far from clear what will be done to fix the computer problems. (“There was no clear explanation of what was going wrong. There was no timetable for when it would be fixed. Obama repeatedly said that he was angry, but he sounded ebullient.”) I couldn’t agree more that “[e]ither the Web site will be fixed in a reasonable time frame, and the law will work, or it won’t be fixed and the law will begin to fail.”
There is, however, a fundamental problem with the defense that “the computer is bad, the law is good,” which the president made today: It’s not true. The administration in fact has delayed significant provisions precisely because those don’t work either (e.g. the employer mandate, the out-of-pocket cap). The loss in coverage and the not-so-affordable costs of insurance don’t have to do with the Web site; these issue have to do with the assumptions and incentives built into the law.
Obamacare falsely assumed governors would expand Medicaid. Obamacare falsely assumed that most young people under penalty of fines would feel compelled to sign up for insurance they didn’t want. Obamacare falsely assumed that with subsidies, the overwhelming number of working poor would spend money on health insurance and not on clothing, housing, food or other expenses. And Obamacare assumed that expanded insurance would lead to better health-care outcomes, a proposition now in doubt due to the Oregon study of Medicaid recipients.
Republicans’ argument that small incremental changes are preferable in the health-care arena has never had a more receptive audience. If we suspended Obamacare exchanges (or made them entirely voluntary), gave states flexibility in expanding Medicaid, gave individual-purchased insurance plans the same tax treatment as employer-provided plans and put money into healthcare (such as increasing the number of local clinics), there is little doubt we’d be better off than with the current Obamacare mess. So where are the Republicans? They should be coming up with, at the very least, an outline of an alternative, one that sounds a whole lot more plausible than the current mess. That would really put the pressure on the White House.