The talking heads are calling this year’s snafus in the roll-out of the Affordable Care Act Obama’s Katrina, likening it to the FEMA debacle in responding to the deadly 2005 hurricane that wasted Louisiana. I think the handling of the ACA roll-out is worse.
Katrina is a code word for an epic bureaucratic screw-up, a failed response to a crisis…but Katrina itself was an act of nature and not created by the George W. Bush. The ACA was a complex policy accomplishment, the manmade creation of the Obama administration. While snafus in ACA, especially the website shortcomings, were also the product of government ineptitude or worse, the various interrelated ACA problems have been exacerbated by the President’s abysmal or nonexistent communication strategy… his abject failure to use his bully pulpit to explain effectively the law’s rationale and why it is important public policy.
All major policy changes have had dodgy roll-outs. Think Social Security, Medicare and Medicaid at the federal level and at the state level the earliest stages of the Massachusetts “Romneycare” health policy implementation. No one expected everything to run smoothly in October, but we reasonably expected that by November those who wished to enroll could indeed do so. The President has apologized for the glitches, but this may be too little too late if promised corrections are not made by the end of this month.
The signature accomplishment of his Presidency could become the signature and defining failure.
Obama compounded the technical problems by constantly declaring that those who wanted to keep their current coverage could do so. The small print, of course, was that they could keep the policies if the coverage crossed a certain minimum threshold. Policies that ripped people off, with low premiums but humungous deductibles and crippling restrictions, could not continue to be offered. But rarely, if ever, did the President use his bully pulpit to explain that there would be a transition into policies that actually covered enough health care to be meaningful. Following that, if enough people traded up, the overall costs would be kept down.
I am left wondering if, with all the attention Obama paid to the politics of the Affordable Care Act, he really understood the policy minutiae that he needed to lay out for the American people. [Is it better to think he was naïve, stupid or mendacious?] The Affordable Care Act was not a great leap toward universal health care, which our wealthy and powerful nation has desperately needed, but a distinctively American pragmatic, free enterprise, private sector-rooted response to a critical problem. It started as a Republican think tank recommendation.
Few did a better job of explaining the individual mandate concept than did Mitt Romney, who as governor decried the uncovered “invulnerable” free riders of the health care system whose use of expensive emergency rooms as their primary care option drove up healthcare premiums and everyone else’s taxes.
But the President rarely, if ever, made the ACA case with clarity or energy. He failed to tell compelling stories or even share memorable anecdotes. As one Facebook writer suggested, the President should have said, in response to recent troubles, “I underestimated the affection many Americans have for being ripped off by unscrupulous insurance companies.” He should never have made an absolute promise of an untruth. Even hyped up detergent advertising limits itself to 99.8 percent pure claims.
Obama could have asked for regulations that required red letter warnings on all substandard policies, like the horrific pictures on cigarette packs. He should have advocated regulations requiring the so-called invulnerable opt-outers to sign informed consent forms acknowledging that they knew that their bargain rate insurance policies would be worthless in the face of named health crises and that, in keeping their defective policies, they voluntarily would chose bankruptcy rather than take a penny of any taxpayer-subsidized hospital services.
According to a recent Quinnipiac poll, a majority of Americans for the first time in his Presidency view Obama as dishonest and untrustworthy . And he brought it on himself. The master orator has been a terrible communicator, too little, too late and too sketchy. His last minute scrambling to adjust the law to permit the continuation of substandard plans confuses consumers, state regulators and insurance companies. It does not inspire confidence.
Presidential lying does not necessarily limit one’s legacy or post presidency earning power. Just ask Ronald Reagan or Bill Clinton. But it can irrevocably diminish second- term effectiveness. Obama has handed the Republicans a hammer to wield in the mid-term elections. It’s a gift to make people forget about the government shutdown and GOP’s persistent failure to articulate a positive alternative to ACA and other Obama proposals .
Even many Democrats are now angry with him, especially those concerned about losing races in 2014. There’s still time to salvage public acceptance of the ACA, but the Administration had better get the website up and running smoothly post Thanksgiving. Or this once heralded landmark law could become an indigestible turkey, and this president will fast become a lame duck.
I welcome your comments in the section below.