If the argument over Obamacare could be confined to the political arena, it would be a no-brainer to say that Republicans should sit back and watch the Democrats stew in their own juices as the law implodes.
But we are far past the point of simple politics. The rollout of Obamacare has thrown the United States into an unprecedented crisis. Unprecedented because it has been caused by the monumental hubris of the Democratic Party, which actually believed it could legislate reform for one-sixth of the U.S. economy without ghastly unanticipated consequences. And the crisis is unprecedented because there is no similar case on record where the towering incompetence of a president and his administration has led the country into an inferno that we will be lucky to emerge from with only singed fingers.
Yes, a crisis, my Democratic friends. It’s a crisis that threatens individuals, families, businesses, and the economy as a whole. No doubt, there are some Americans benefiting from Obamacare. The expansion of Medicaid is going to give minimal health care to people who had none before. Some Americans are going to see a reduction in their health insurance premiums thanks to the generous subsidies being offered. And the chronically ill won’t have to pay any more for insurance than anyone else and they can’t be turned down.
These are positives, although at what cost to the Treasury and the health care industry is one of those “unanticipated consequences” that Obamacare is unfortunately becoming famous for. And it’s absurd to think we needed a 2,000 page bill that has tossed the health care industry on its head to realize those gains.
The crisis in Obamacare’s rollout is a snowball going downhill as each successive problem leads to more consequences that breed additional problems. For example, Obamacare mandates have caused cancelled policies for millions of people — and there will be tens of millions more when the employer mandate looms next fall. Those who got their insurance company “Dear John” letter were being told to log on to the exchanges in order to purchase new plans that would meet Obamacare’s strict specifications.
But they can’t do that now. The federal hub is down for the count and despite assurances it will be operational by the end of this month, Jim Geraghty links to a story about the geeks involved with the fixes who don’t think they’ll even be close to ready on November 30:
Software engineers and tech analysts scrambling to fix HealthCare.gov are discovering new problems by the day, as early fixes take hold and users are able to navigate more deeply into the troubled online application process, administration officials said Thursday.
“We are seeing volume go further down the application. What that means is we are identifying new issues,” said Julie Bataille, communications director of the Center for Medicare and Medicaid Services, the agency overseeing the site improvement.
“As volume is exposed to the system, we are identifying new issues, adding them to the punch list and working through them,” she said.
It’s not only the website. The information and calculations coming from the exchanges may be wildly inaccurate.
About 8,000 Washington residents will soon receive letters informing them that the price they are expecting to pay for health insurance purchased on the new online exchange marketplace is incorrect.
The letters are part of an effort by the Washington Health Benefit Exchange, which operates the exchange, to correct a major error that resulted in the miscalculation of tax credits that help qualified enrollees pay for insurance premiums.
To compound the problem even further, the well-known security problems with the site are even worse than anyone could have dreamed:
CBS News has learned that the project manager in charge of building the federal health care website was apparently kept in the dark about serious failures in the website’s security. Those failures could lead to identity theft among buying insurance. The project manager testified to congressional investigators behind closed doors, but CBS News has obtained the first look at a partial transcript of his testimony.
Henry Chao, HealthCare.gov’s chief project manager at the Centers for Medicare and Medicaid Services (CMS), gave nine hours of closed-door testimony to the House Oversight Committee in advance of this week’s hearing. In excerpts CBS News has obtained, Chao was asked about a memo that outlined important security risks discovered in the insurance system.
Chao said he was unaware of a Sept. 3 government memo written by another senior official at CMS. It found two high-risk issues, which are redacted for security reasons. The memo said “the threat and risk potential (to the system) is limitless.” The memo shows CMS gave deadlines of mid-2014 and early 2015 to address them.
But Chao testified he’d been told the opposite.
We last heard from Mr. Chao back in March, when he expressed the hope that navigating on the exchange wouldn’t become a “third world experience.” At this point, it would be a gigantic step upward if that worry would become reality.
Now, he is being lied to by his own people about the “limitless” security risks on healthcare.gov. The administration is deliberately encouraging people to use a website where the chances appear excellent that their personal information will be hacked. Lambs to the slaughter.
An inoperative, glaringly unsecured website which dispenses inaccurate information that millions of people need to access to continue carrying health insurance is a crisis. The radical rise in costs for millions is a crisis. A law that won’t allow cancer patients to continue to see the doctors who are keeping them alive is a crisis. Hiring navigators who haven’t been vetted for a criminal past and giving them access to consumers’ personal information is a crisis. A cynical lie told to people that they could keep their insurance if they liked it has led to a crisis in presidential credibility that perhaps only Nixonian lies about Watergate exceed.
It would be wonderful for Republican prospects in 2014 to ignore all of this, stand on a soap box, and rail against the villains who brought this crisis upon us. It would also be grossly irresponsible. Some Republicans appear to be resisting that temptation and are trying to work with Democrats to pass some Obamacare “fixes” that would deal with at least some of the problems that have created the crisis.
There are bills in both houses of Congress that would delay the individual mandate for a year. This is a band aid that, at the moment, doesn’t have much of a chance. But as we get closer to January 1, 2014, without a working website, those chances will improve.
The most popular bill introduced to date and the one with a decent chance of being passed by both the House and the Senate is the “Keep Your Health Plan Act.” Introduced by Michigan Congressman Fred Upton, the bill authorizes insurance companies to offer plans to consumers that have already been cancelled or are scheduled to be cancelled. The bill has more than 100 co-sponsors, including Rep. John Barrow of Georgia, a Democrat. There are probably a baker’s dozen of Democrats — mostly vulnerable freshmen — who are likely to vote for the bill.
The Senate version, introduced by Ron Johnson, is slightly different than Upton’s bill:
The House and Senate bills differ, with Upton’s legislation taking a broader swipe at the law. It would allow all plans that existed on the individual market on January 1, 2013, to stay in effect through 2014, but also would go a step further, giving everybody — not just those who had the plans previously — the opportunity to purchase them. The Johnson bill, by contrast, would merely allow individuals to keep, in perpetuity, plans they had at any point between the enactment of Obamacare and December 31, 2013.
What began as a mild tweak at President Obama when the Upton bill was introduced the last week in October, scoring him on his broken promise, has become a genuine effort to give relief to millions of Americans. And despite White House opposition, some form of the bill may pass both chambers. Even Bill Clinton has come out in favor of allowing people to keep their plans if they like them.
The House will vote on Upton’s bill on Friday. No vote is scheduled yet in the Senate on Johnson’s bill, but several vulnerable Democrats have introduced their own measures to make the president keep his promise. Whether Harry Reid will stand in the way of these bills may depend on how vigorously the White House will oppose the measures.
But the Upton-Johnson bills have major flaws, according to the insurance industry. First, the Upton bill does not compel the insurance companies to continue to offer the plans; it only authorizes them to do so. Second, the actuarial models that Obamacare is dependent upon would be radically skewed if millions of healthy people holding individual insurance policies were able to keep them, thus allowing them to remain outside the insurance marketplace.
And there are other gripes from insurance companies:
Zirkelbach of AHIP pointed to two other concerns insurers have with the Upton bill. The first is that insurance is heavily regulated on the state level, so federal permission wouldn’t necessarily be enough to allow plans to continue. Second, he noted that some insurance policies have already been canceled or replaced based on existing laws and regulations. “The question is, could those policies be opened back up?” he said. “And how long would that take, how would states respond and what impact would that have?”
There’s also the view that insurance plans will ultimately have to offer a basic standard of coverage, as Obamacare intended, and it makes little sense to delay the inevitable.
The “Keep Your Health Plan Act” doesn’t sound like much of a fix after all. Millions would still lose their coverage and matters may even be made worse by the confusion.
Is it time for Republicans to dust off the “repeal and replace” option and work to sub out most of the Obamacare legislation? During the three years that the Affordable Care Act has been in existence, it has spread its tentacles throughout the government and the health care industry. Thousands of pages of rules have been written. States have voted and governors have accepted Medicaid expansion. Insurance companies have radically altered their policies and ways of doing business to comply with the law. Big Pharma, doctors, hospitals, all manner of health care providers — all have geared up and made the changes necessary to comply with the law. Ripping out Obamacare when it is this heavily entrenched would do far more damage to the health care system than the law itself has already caused.
There are fixes beyond delaying the mandate and allowing people to keep their insurance. But to make it happen, the GOP is going to have to partner with like-minded Democrats to bring about truly bi-partisan reform. If the crisis continues to get worse — and there is nothing that we’ve seen to contradict that notion — the pressure on Democrats to agree to reforms will continue to grow.
The political risk to Republicans of staying on the sidelines while the country burns is just as great as the risk to Democrats of doing nothing. People are angry, frightened, and confused. It’s time to show the voters that the Republican Party is worthy of governing by acting responsibly in the face of a serious crisis not of their own making. Voters aren’t stupid. They will know whom to blame for this fiasco.
And they’ll also know whom to punish if the GOP obstructionists get their way and prevent the Congress from trying to fix this mess.