Dec 12, 2013
Plenty of Time to Fix Obamacare
Posted on Nov 1, 2013
It takes chutzpah, or perhaps just an extraordinary lack of self-awareness, to argue vehemently that a program should never be implemented—and then complain it isn’t being implemented well enough.
But that seems to be the new Republican position: We want the Affordable Care Act, and we want it now.
Given that House Republicans have voted dozens of times to repeal Obamacare, you’d think more of them would be cheering the “debacle” of a barely functioning website that keeps people from signing up. Instead, they demand to know who is responsible and insist that heads should roll.
The sense of urgency surrounding the program is palpable—and largely artificial. The Obama administration royally screwed up the launch, no question about it. But there’s time to get it right. Plenty of time.
The real deadline for creating a sleek, seamless, customer-friendly website allowing people to buy insurance through the federal exchanges isn’t three weeks or even three months. It’s three years and change—the time President Obama has left in office.
So everyone can take a deep breath and calm down. The state exchanges are working fine. The first task with the federal website is to make sure the flow of information to and from insurance companies is reliable and accurate. This whole scheme doesn’t work unless insurers know whom they are insuring.
As far as the user experience is concerned, the goal right now should be to make it easier for people to do comparison shopping before the system insists on trying to verify their life stories. By the time applicants have made their decisions and are ready to buy, the website will probably still be clumsy and aggravating. But engineers should have applied enough duct tape and baling wire to make it at least functional.
Meanwhile, there ought to be a separate team working on a whole new website with different architecture. I say this as a non-techie who has only a vague notion of what “architecture” means regarding computer systems, but who knows a total lemon when he sees one.
“Hold me accountable for the debacle. I’m responsible,” said Health and Human Services Secretary Kathleen Sebelius as she faced House inquisitors Wednesday in the first of what surely will be many investigative hearings.
Indeed, Sebelius must shoulder most of the responsibility for the late-night punch line that is HealthCare.gov. It’s shocking that the website was made operational—or, in this case, non-operational—with so little testing. It’s even more shocking that the little testing that was done indicated there would be problems, yet the whole administration seemed unprepared when the predicted problems appeared.
But there is plenty of blame to go around. Some of it must fall to Obama, who hurt his own cause by making categorical statements about the program that were not categorically true.
He said many times that Americans who are happy with their current health insurance can keep it. This is true for almost all the insured—almost, but not quite. Of the 19 million people in the individual-insurance marketplace, estimates are that at least half will not be able to keep their policies because they do not meet the Affordable Care Act’s standards.
There are good reasons why. Many of these policies offer little coverage and impose substantial out-of-pocket costs that discourage regular doctor visits. The Affordable Care Act exchanges and subsidies will offer many people better insurance at a lower cost.
Still, it was careless, at best, for Obama to make that unqualified keep-your-insurance promise—and make it so many times—without explaining the fine print. So now, he not only has to convince people that the website will eventually work. He also must counter his opponents’ allegations that he was less than honest about the true impact of his signature domestic accomplishment.
The word debacle does fit the rollout. But the policy itself is sound, and eventually all the noise will fade. The first weeks of Obamacare will be forgotten. The first months will become a footnote. The first years are what will matter.
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