Ronald Reagan famously said, “The nine most terrifying words in the English language are, ‘I’m from the government and I’m here to help.” Obamacare, more than any piece of legislation in recent memory, is proving just how right Reagan was.
President Obama’s health care bill, ironically called the Patient Protection and Affordable Care Act, was passed with promises to reduce health care costs, lower insurance premiums and expand health care coverage. But on nearly every front it has been a colossal disappointment, in no small part because the federal government is fundamentally ill-equipped to implement its heavy-handed provisions. And that’s beginning to make a lot of Democrats angry. Take Time’s Joe Klein for example:
“Let me try to understand this: the key incentive for small business to support Obamacare was that they would be able to shop for the best deals in health care superstores – called exchanges. The Administration has had three years to set up these exchanges. It has failed to do so.
. . . [T]he Obama Administration has announced that it won’t have the exchanges ready in time, that small businesses will be offered one choice for the time being – for a year, at least. No doubt, small business owners will be skeptical of the Obama Administration’s belief in the efficacy of the market system to produce prices through competition. That was supposed to be the point of this plan.”
The inability of the federal government to get the special exchanges for small businesses is just the latest sign of implementation trouble. The largest looming problem is that the broader system of exchanges – where Obamacare envisioned consumers in the individual health care market could go and shop for health care plans –are nowhere close to being ready by the October 1 deadline. To be fair, the project is immense. The system needs to interface with a variety of different data sources including the IRS and state governments to make eligibility determinations, it needs to have strong privacy protections to meet HIPAA regulations , it needs to be able to enroll new people into plans, it needs to provide a shopping experience tailored to the consumer, and it needs to have a customer service outlet to answer questions and handle problems.
All of this is very costly, very intricate and takes a lot of time. A poll of health care executives showed widespread pessimism that the federal government will be able to get everything done on time. The poll showed that a whopping 70.7% said Washington wouldn’t meet their October goal. Unfortunately, the Obama Administration is equally gloomy.
“We are under 200 days from open enrollment,” Henry Chao, deputy chief information officer at the Centers for Medicare and Medicaid Services said, “I’m pretty nervous – I don’t know about you.”
“The time for debating about the size of the text on the screen, or the color, or is it a world-class user experience, that’s what we used to talk about two years ago,” said Chao. “Let’s just make sure it’s not a third-world experience.”
Sadly, given the law’s past, even that may be setting the bar a little high. Obamacare has already failed in many ways, from the short-lived CLASS program that was repealed because actuaries predicted it would cause an insurance “death spiral,” to the flop of the high risk pools that attracted fewer customers and cost more than expected. And that’s before you even discuss the failure to meet the deadline for the Basic Health Program, the glitches causing people to be denied federal tax credits, and utter debacle that is the Accountable Care Organization pilot program. Oh, and did I mention that even trying to understand the parts of the bill that the Administration has actually gotten around to explaining is next to impossible because the regulations look like this:
Republicans have long understood that the federal government, despite its best intentions, is simply incapable of efficiently managing large projects. Obamacare’s implementation may finally convince Democrats of the same.