The biggest joke of the Obama presidency
This post originally appeared in National Journal.
The Obamacare rollout is dying the death of a thousand zeitgeists.
The jokes are too easy. But President Obama has never been this juicy a target or the comic barrage this pitiless.
In his Rose Garden defense of Obamacare, the president said "the product is good" and that it was a "good deal" four times each. He said it was "really good," "the prices are good," the "health insurance is good," and the quality was "really good" one time each. The only thing he didn't say was, "Message: I care."
Every politician lives with a secondary metaphoric shadow of huckster. But Ginsu knives and George Foreman? Can Ron Popeil and Chop-O-Matic comparisons be far away?
Oh wait. See Jon Stewart at 5:55 of this clip. Stewart also lampooned Obama for borrowing George W. Bush's save-Iraq-at-the-last-minute argot of a "surge" (see same clip at 7:28) while Daily Show correspondent John Oliver (at 7:47) dodged Pac-Man inside the antiquated and crappily coded world of HealthCare.gov (where 4's and 5's exist instead of 0's and 1's).
To paraphrase Lyndon Johnson about the Vietnam War: When you've lost Jon Stewart ...
Obama's team has a legitimate story about the problems with the site. But its stubborn refusal to admit structural flaws with the site design, inadequate beta testing, and the now hysterical prelaunch hype about the ease of the website use--as easy as buying "a plane ticket on Kayak"--have buried that story under an avalanche of obfuscation.
The story goes like this. Obama's direction and emphasis were on creating an insurance product in all 50 states that would create genuine competition, meet the minimum care standards that Obamacare set, and provide a range of options above basic care--the bronze, silver, gold, and platinum plans. Obama's biggest fear was not that the federal website wouldn't work but that it wouldn't have a product to sell in the first place. Legal challenges at the state and federal level slowed the formation of insurance marketplaces. Various waivers and exemptions also muddied the process. Nothing was launched fully until after the Supreme Court upheld his health reform act. In briefings on the law's implementation, Obama sought and received regular updates on the insurance products and the level of cooperation at the state level on insurance options and Medicaid availability--not the development of the federal website. These are plausible, though not entirely foolproof, explanations for the website's woes. They could help the White House navigate the currently choppy website waters.
There's a kayak in this story all right. The White House is in it and up the creek, and it threw away the paddle.
- HealthCare.gov pricing feature can be off the mark
- How long can Obamacare survive with website woes?
The biting criticism and deepening (although the White House believes it will be transient) Democratic anxiety about HealthCare.gov points to deeper concerns about the law itself and Obama's ability to make it--and thereby the Democratic vision of government--work practically and politically.
Obama said it in the Rose Garden. "We did not wage this long and contentious battle just around a website."
So true. But for Obamacare to work, so much more than the website has to function to meet the needs of the uninsured and the insured. One of the reasons the website is so horribly garbled is that the administration decided it didn't want consumers to see the price of insurance premiums without also being able to see if they were eligible for offsetting subsidies. That was not a design flaw as much as it was a tacit admission that the price point of insurance coverage could stun consumers. Here is a national map, based on available data of pre- and post-Obamacare premiums.
There is also the question of how those currently insured will fare under the new, more expansive insurance requirements. Anecdotal evidence has begun to surface that premiums and deductibles for those with insurance either are or will be on an upward march. There's even evidence of dissatisfaction with premiums and deductibles on HealthCare.gov's own Facebook page. Other analysts worry that younger and healthier Americans without insurance might flee Obamacare coverage because premiums and deductibles are too expensive. The fear is that opting for a "skinny" insurance plan--permissible under the law without incurring penalties--will deprive Obamacare of the essential revenue necessary to finance coverage for older, sicker Americans.
All of this goes to the basic architecture of the law. If that is flawed, the woes for Obama will be much deeper than they are now.
Public skepticism borders on fear. According to the latest CBS News poll, only 43 percent of Americans approve of Obamacare. That's exactly the same number as CBS found in May 2010. Forty-three percent of those surveyed believe the law goes "too far" in changing the health care system. When asked about Obamacare's future effect in their lives, 53 percent said it would "increase" their costs, and 40 percent said their care would "get worse." Only 14 percent said Obamacare would save them money, and 16 percent said their health care would "get better."
Polling on Obamacare has remained relatively stable since it was passed in 2010. But the law is now real, and Obama owns all of it--as the brutal battering over its inept website indicates. If anything, Obama entered the rollout of his health care law with a presumption he would get the technical part right. After all, Obama has from the start exuded and personified the ineffable elan of the iPhone/Zappos/Instagram era. Screwing up the tech part deepens anxiety about the nontech part.
That's why Obama must fret about death by a thousand zeitgeists.
