About President Obama’s remarks on Monday in the Rose Garden on the matter of the problems plaguing the Affordable Care Act and, specifically, healthcare.gov, it seemed to me that they served a valuable purpose, at least to this extent: They distilled the Obama presidency to some of its core qualities: (a) detachment from reality; (b) misleading in its claims; (c) deeply polarizing and partisan; and (d) filled with lame excuses.
But there was another noteworthy element to what the president said. I have in mind the pitiable quality of his remarks. Speaking about the Affordable Care Act, Mr. Obama kept insisting–over and over and over again–how good the product is, how really and exceptionally good it is, how popular it is, and how things really and truly will work out.
Methinks he doth trieth too hard. The president spoke about ObamaCare as if it were a work of art, one or two brushstrokes away from being a masterpiece. Which created the impression that the president is living in a make believe world.
Several additional observations on the president’s remarks:
1. For Mr. Obama to say the rollout of healthcare.gov hasn’t worked as “smoothly as it was supposed to work” is a bit like the captain of the Titanic saying the trip wasn’t going quite as smoothly as planned. For one thing, there are a spate of stories today (like this one) detailing that the administration launched healthcare.gov despite ample and repeated warnings that the system wasn’t ready. As for going forward, the solutions aren’t simple or obvious. There is no General Petraeus who will step forward to lead the “tech surge.”
The problems plaguing the system are deep, massive and structural in nature. And if they’re not fixed within the next five weeks–and there are increasingly reasons to believe the problems might not be solved by then–it might well force the president to unilaterally delay the individual mandate. After all, you can’t penalize people for not joining a program that is nearly impossible for them to sign up for.
Between now and the end of the year the Obama administration is counting on roughly three million people (out of a total of seven million) to sign up. They probably won’t get that, and they may not get even close to that.
2. The difficulties the administration faces go beyond just the number of people who sign up. It also depends on who they are. To be more precise: for the online federal health-care exchange to succeed, it needs healthy people, not just sick ones, to enroll in order to make the system work.
Here’s the problem: people with pre-existing conditions have a tremendous incentive to spend day and night signing up on the exchanges. That is, I take it, what happened with Janice Baker, who introduced the president at yesterday’s event. In Ms. Baker’s own words, it took her a “number of frustrating attempts before I could apply for and select my plan.” She had a pre-existing health condition. On the flip side, healthy–and particularly young and healthy–people might try a couple of times and quit trying to enroll. If that happens, of course, premiums and deductibles will skyrocket, which will further accelerate this problematic cycle. This is known in the insurance industry as a “death spiral.” And that may be what awaits the ACA.
3. The administration has made a great deal about 476,000 people starting the process of enrollment. Except they haven’t. What administration officials are referring to is the number of people who have started an account, which isn’t the same as the number of people who have enrolled. In fact, the number of people who have enrolled is undoubtedly a fraction of the 476,000 figure. The most transparent administration in history knows the number but refuses to tell us. Why? Because they’re embarrassed at how low the figure is.
4. Mr. Obama, who at this point in his presidency has developed certain stale and unhealthy rhetorical habits, mocked Republicans and said it’s time for them to “stop rooting for [ObamaCare’s] failures.” But the problem the president faces isn’t Republicans rooting for its failures; it’s that the program is collapsing on its own. The GOP had nothing to do with its development. The president desperately wishes he could share the blame for what has gone wrong. Except that every Republican in Congress opposed the Affordable Care Act. This is Barack Obama’s signature achievement; he and his party are joined at the hip to it. They are as inseparable as salt and water in the ocean.
5. Yesterday President Obama was trying to win a news cycle. Yet in the process he is–with each false claim, with each soon-to-be-revised reassurance, and with each discredited defense–burning up his credibility. The walls of reality are closing in on the president.
The failures of the rollout of the federal health-care exchange is just the latest in a long train of mistakes in this deeply unpopular program. If the individual mandate is delayed, it will obviously be a huge embarrassment for the president. Moreover, if the problems with ObamaCare continue and mount, it becomes a huge political liability for the Democratic Party. Remember: Health care was a very significant issue in the 2010 mid-term elections, which saw historic gains by the GOP. In 2014, ObamaCare could be an even bigger issue, since abstract concerns in 2010 will be replaced by concrete anger and outrage in 2014.
6. There’s a reason reporters who cover the White House say that top aides and even the president are deeply unsettled. It’s not just that what he considers his legacy achievement looks to be imploding before our eyes, which would be bad enough. There’s something else going on as well.
The Affordable Care Act or close approximations of it is something liberals have worked toward for generations. It has been, for the left, a kind of talisman; to have had it codified in law ranks as one of the great liberal achievements in American history. Or so the left thought. They probably should have been more careful in what they asked for. As Ryan Lizza of the New Yorker put it, “The ACA is the most important liberal project in decades. If it fails, it is a complete disaster for liberalism.”
Correct. And if you go to the scorecard, you’ll see that the ACA is failing. That the great and mighty Obama seems powerless to stop it. And that ObamaCare may become an ever more complete disaster for liberalism than it is now. Which is saying something.