The bullet, of course, is the disastrous rollout of the government’s sign-up website for federal health insurance exchanges, which has prevented countless Americans from signing up for health coverage. The dodge was graciously provided by the House Republican caucus, which chose to distract the public’s attention with its quixotic effort to “defund” the Affordable Care Act by shutting down the government, thus placing the workaday financial pain facing millions of America’s at the top of the news cycle. Thanks, Sen. Ted Cruz, R-Texas!
Enemies of Obamacare will seize on the botched rollout as evidence that government can’t do anything right, and therefore that Obamacare itself is hopelessly flawed. A few points to put this viewpoint in perspective.
1. Complex systems are always subject to unexpected problems at the outset, whether they’re hosted by the public or private sector. If you think that the private sector is invariably the answer, I have two words for you: San Onofre.
2. While the federal website is still seriously glitch-prone, 15 state exchange websites, especially in states that committed themselves to a smooth rollout of the ACA, are working through their shakedown problems. The California exchange, Covered California, reported that after one week of operation, 29,000 Californians had applied for coverage, with an additional 27,000 applications pending. That’s despite a heavy application rate that “blew the socks off anything we expected,” as the exchange’s director, Peter Lee, told my colleague Chad Terhune.
Other states are also doing well. (Thanks to Charles Ornstein of Propublica for this roundup.) In Kentucky, where Gov. Steve Beshear, a Democrat, stands foursquare behind Obamacare, 9,453 residents have been enrolled in the exchanges or for expanded Medicaid coverage. That’s notable because the state’s two Republican U.S. Senators, Mitch McConnell and Rand Paul, have moved heaven and Earth to cripple the act. (Beshear called them out in a recent op-ed piece describing how much money the act will save Kentucky: “Frankly, we can’t implement the Affordable Care Act fast enough,” he wrote.)
3. While much of the blame for the federal screw-up belongs to poor planning and awful software design--this piece by a software engineer lays out the bad decisions underlying the disaster--the problems also arise from the ill will of Obamacare’s sworn enemies. As Henry Aaron of the Brookings Institution observes, these opponents have behaved outrageously by “actively trying to make the law fail.” Officials in Georgia, Florida and Missouri deliberately placed roadblocks in the way of “navigators” whose job is to help residents sign up.
Dozens of Republican-led states refused to implement their own state exchanges, leaving the task to the federal government, which was consequently overwhelmed by the task of managing the different systems of 36 states. You don’t think the feds can handle the job? Then you should have taken it on yourselves; then your constituents would have been as well-served as those of California and Kentucky.
4. Finally, it’s important not to let the botch that is the federal website distract us from the fundamental achievement of the ACA, which is a sea change in the standards that govern the accessibility and cost of health insurance for as many as 30 million Americans for whom coverage was previously out of reach.
Governors and legislatures that think the best way to respond to a program that will serve millions of Americans, most of them at the lower end of the income scale, is to throw wrenches into the works don’t deserve to be part of the national conversation on healthcare.