The technology doesn’t even exist to make the state insurance exchanges work in the way that the law intends. And the dirty little secret is that the administration has known this fact for months.
From the National Journal:
In an ideal world, the exchange websites need to be able to talk to several federal agencies—IRS to verify an applicant’s income and employment status, the Department of Homeland Security to determine her citizenship, and the state government to see if she qualifies for Medicaid, to name a few—all in real time, so a person could fill out a form and purchase insurance in one sitting.
Each of those departments has its own computer system and its own means of tracking information. Creating a “data hub” to share them has been a challenge, as a recent Government Accountability Office report highlighted. It is increasingly clear that the kind of Amazon.com, one-stop shopping that was once described – and that Obama himself referenced in a speech on Monday — will not be available in most parts of the country.
One health professional summed up the massively complex system thusly:
“It’s the joyous, simultaneous, nonlinear equation from hell,” said Kip Piper, a former top official at HHS and OMB who is now a consultant in close contact with IT vendors. Piper said it’s no surprise that the administration has given up on certain functions given the technological complexity needed and the short time-frame.
The constitutionality of dropping requirements or delaying mandates (see this article for more fudging on the law’s requirements by the administration) may be in question, but there is no argument that they are doing it because they are desperate. Their desperation is not a result of any interference by Republicans. The administration is running around with its hair on fire because of decisions they made all by themselves. They had three years to bring this program online and will fail because of their own incompetence and imprudence.
It is amazing that the president is still lying about how the exchanges will work at this late date. Indeed, most of the major promises the president made about Obamacare in his joint session of Congress speech on September 9, 2009, have fallen by the wayside. Millions of Americans won’t be able to keep their insurance if they want to. The idea that Obamacare will make insurance more affordable is a bad joke. The program’s cost has already nearly doubled from its original price tag.
The narrative the Democratic partisans mentioned above are trying to push is that all of these problems are the result of GOP obstructionism. If they had only done everything the president wanted, given the administration every dime they needed, and enthusiastically pitched in to inform the American public about the coming changes, everything would be peaches and cream and Obamacare would be a hit.
It’s nonsense, of course. Obamacare doesn’t need GOP obstructionism to be a disaster in both the near and long term. The exchanges may eventually become workable, although the time frame might be measured in years rather than months. Medicaid expansion won’t be too bad at first, but given the program’s ill health, you wonder how long it will be before signs of collapse set in.
Even hikes in insurance premiums may level off eventually, although that is by no means certain. In short, even with GOP obstructionism, the program will probably muddle through.
But Republicans aren’t obstructing this law because it will become one more entitlement that’s going to add to the deficit, or because they hate Obama. They are obstructing the implementation of a law that fundamentally alters the relationship between the government and the governed — alters that equation in ways that are at odds with the purposes and intent of the Founders. We embrace first principles because they supply an anchor to our past that allows us to maintain fundamental ideas of freedom and liberty in any age, under any government run by any party. Obamacare runs counter to some of those notions of liberty because it takes so many decisions about one’s personal and private life away from the individual and places it with the collective.
The obstruction charge relating to such a law should be embraced by the party, not denied.