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Why reselling Obamacare won’t be easy

Seven weeks after's troubled launch, President Obama is hoping to (re)focus Americans' attention on both the benefits of his signature health-care law and the Republicans' effort to undermine it. But this strategy faces its own set of challenges, which may be hard to overcome even as the administration makes progress in fixing the online enrollment system.

President Obama addressed problems with the Affordable Care Act at the annual meeting of the Wall Street Journal's CEO council in Washington Tuesday.

On Wednesday morning, the White House Council of Economic Advisers suggested that the Affordable Care Act had helped slow the growth in health-care spending, in part because it helps reduce Medicare overpayments to private insurers and medical providers.

Not only is this a fairly abstract concept -- most Americans couldn't name the annual increase in national health-care costs if you asked -- but even as CEA chairman Jason Furman briefed reporters on these findings in the Eisenhower Executive Office Building, the insurance industry's largest trade association sent out a press release blasting the very provisions Furman was touting.

"More than 14 million seniors and individuals with disabilities, or roughly 28 percent of all Medicare beneficiaries, have chosen to enroll in a Medicare Advantage plan because of the better services, higher-quality care, and additional benefits these plans provide," wrote America’s Health Insurance Plans’ president and CEO Karen Ignagni  in a letter Wednesday to the Centers for Medicare and Medicaid Services. "While the program is valued by beneficiaries, it is facing a future of severe underfunding due to a combination of legislative and regulatory actions in recent years."

Insurers are theoretically aligned with the White House in the effort to sell the new health-care law, since they're eager to enroll new customers. But it's an uncomfortable partnership, since each side has accused the other of putting consumers in a difficult position when it comes to the cancellation of health plans sold on the individual market.

Another traditional White House ally in this fight is state insurance commissioners, many of whom view the law as critical to expanding health-care coverage for their residents. But they're likely to complain to the president Wednesday afternoon about the fact that they were caught off guard by his proposal to extend the sale of individual plans for a year even though those plans fail to meet the bedrock requirements of the Affordable Care Act.

Even as he takes friendly fire on the health-care law, the president must also manage a busy schedule as he seeks to promote other high-priority policy initiatives. On Tuesday, for example, Obama met with a bipartisan group of senators at the White House in a two-hour session designed to persuade them to hold off on new sanctions against Iran, with a second round of negotiations to freeze elements of the country’s nuclear program set to begin this week.

Obama’s problem with messaging is not the only consequence of a schedule crowded with ceremonial events and the delicate politics of Iran’s nuclear program. He also faces a problem with consistency.

Last week, Obama offered a self-critical view of the disastrous health-care rollout, saying several times that the poor result is “on me.”

His appearance before the media followed an apology to Americans who are receiving health-insurance policy cancellation notices, something he had repeatedly assured the public would not happen. His trustworthiness, a quality Obama had always rated high on with the public, has plummeted in a series of recent polls.

But on Tuesday, Obama emphasized to a group of Wall Street chief executives that he alone was not to blame. He shifted some of the responsibility to Washington’s political dysfunction -- another problem he pledged as a candidate to resolve -- and to the Republican Party. In his remarks, Obama described what he called the Republicans’ “ideological resistance to the idea of dealing with the uninsured and people with preexisting conditions” in any health-care reform. He suggested that he underestimated the depth and enduring nature of that sentiment, more than three years after the law’s passage.

“We should have anticipated that that would create a rockier rollout than if Democrats and Republicans were both invested in success,” Obama said. “One of the problems we've had is one side of Capitol Hill is invested in failure, and that makes, I think, the kind of iterative process of fixing glitches as they come up and fine-tuning the law more challenging.”



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Chris Cillizza · November 20, 2013

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