The best jokes about the absolutely abysmal rollout of Obamacare have come not from the program’s critics but from the Affordable Care Act’s two biggest champions. And the biggest tears? Well, those will come from the rest of us over the coming years, in the form of declining levels of choice in health care and rising prices.
Faced with the manifest—and ongoing—failure of the federal exchange at Healthcare.gov to allow people to shop, compare, and enroll in great new insurance at low, low prices, Barack Obama huffed, “Just a couple of weeks ago, Apple rolled out a new mobile operating system, and within days, they found a glitch, so they fixed it. I don’t remember anybody suggesting Apple should stop selling iPhones or iPads or threatening to shut down the company if they didn’t.”
The president’s comments deliberately echoed that of Health and Human Services Secretary Kathleen Sebelius, who on the launch date pleaded with Americans to “give us the same slack they give Apple…If there’s not quite the operational excellence right away, we’ll continue to press for that.”
Operational excellence? Equating a glitch in an operating system that has revolutionized mobile and tablet computing to an unproven program whose website seems to be infected with the Stuxnet virus? Do these people think we’re Republican-level stupid or what (more on that later)?
Or maybe Obama and Sebelius think that Apple’s bright, shiny future still rests on the eMate 300 and the Newton Message Pad. Seriously, does the president not realize that after a string of flops and cost overruns, Apple did in fact come close to bankruptcy? That happens to companies on a regular basis, even to behemoths that liberal economists like John Kenneth Galbraith used to claim were beyond the reach of market forces. Go ask anybody who remembers A&P, Gimbels, Digital Equipment, Kodak, or Borders, fer chrissakes.
After the search for bin Laden, the Obama administration’s biggest manhunt has turned out to be for someone—anyone—who managed to actually sign up for and enroll in an insurance plan offered by the federal exchange. As The Miami Herald declared in a recent headline, “Obamacare enrollees become urban legend.” So far, you’ve got a better chance of turning up a gerbil escapee scurrying down Richard Gere’s leg than finding a couple dozen satisfied customers of healthcare.gov. During a legendarily awful Daily Show appearance, Sebelius lowered expectations yet further by saying that HHS will release enrollment figures on a monthly basis. Right after all the parades for record-setting grain harvests and successful launches of canine cosmonauts.
The first high-profile case of an Obamacare enrollee was paraded around the mainstream media like a captured U2 pilot in the old Soviet Union. But he turned out to be…well, not so much. On October 4, my colleague Peter Suderman broke the story that Obamacare poster boy Chad Henderson had not actually purchased insurance for either himself or his father. Henderson—a paid activist for Organizing for America, a community organizing project of the Democratic National Committee—eventually admitted to The Washington Post, “I have not purchased a specific plan.”
But how could he have? Healthcare.gov is a colossal, expensive failure that projects a 1970s-era DMV experience into cyberspace. It wasn’t for lack of money. As The New York Times reports in a devastating anatomy of failure, some $400 million has been spent so far in creating “a one-stop click-and-go hub for citizens seeking health insurance.” But rest easy, America, since the Times cites a source who says that “the project was now roughly 70 percent of the way toward operating properly.” And the other 30 percent, which is kinda sorta important? “I’ve heard as little as two weeks or as much as a couple of months.” Which is to say, don’t go skydiving or skiing come January 1, 2014.
There’s reason to believe that by keeping people from actually pricing insurance plans, healthcare.gov is trying to mask the cost of the coverage offered at the exchange. It turns out that the major cause of the traffic bottleneck at healthcare.gov is the requirement that visitors register and give personal information before being allowed to browse for plans—the sort of impediment rarely encountered these days at most e-commerce sites.
HHS told the Wall Street Journal that the goal of that was to “ensure that users were aware of their eligibility for subsidies that could help pay for coverage, before they started seeing the prices of policies.” Avik Roy, a writer at Forbes.com and an analyst at the Manhattan Institute who has been sharply critical of the president’s plan, calculates that coverage under Obamacare will on average be 99 percent higher for men and 62 percent for women than under currently available plans. That’s because Obamacare does away with exclusions for pre-existing conditions, severely caps premiums for older people, mandates coverage of a wider number of services, and more. You can argue whether those are good or bad things, but it’s hard to argue that they don’t increase costs that will ultimately be borne either directly by the insured or indirectly by taxpayes who will subsidize coverage. Roy contends that the “political objective [of] masking the true underlying cost of Obamacare’s insurance plan…far outweighed the operational objective of making the federal website work properly.”
Eventually, the crowd at healthcare.gov will thin out, either because fed-up folks—especially the “young invincibles” who are so important to any chance of the program’s success—stop going there or because the government hires some decent programmers. Whether it’s in two months or 12—and whether it costs another $400 million—is anybody’s guess. But while you’re waiting, consider this: The Congressional Research Service found that the Obama administration missed half of its statutory deadlines for the implementation of The Affordable Care Act in its first three years.
There’s no rush. After the program becomes fully operational, then the real troubles will begin. Who in their right mind is going to feel comfortable giving income and other personal information to a site that inspires less sense of security than a Russian mail-order bride website? The government’s super-spy outfit—the National Security Agency—allowed a short-term contract employee to walk out with a bazillion incriminating PowerPoint slides. And you’re asking us to believe that HHS is going to keep things confidential?
Does it make you feel better that, as the Times put it, the “project quarterback” was the Centers for Medicare and Medicaid Services, which fails to catch between $60 billion and $100 billion annually in waste, fraud, and abuse? Reports are coming in that to the extent that healthcare.gov and related phone centers are sending information to insurers, much of the data is junk that will require huge amounts of manpower to verify.
The one thing that the Obama administration has going for it is opposition by Republicans, which maintains its “stupid party” reputation the old-fashioned way—they earn it. Obamacare has never been popular with voters, even as its unpopularity has declined slightly due to the shutdown. Spectacularly, the Republicans managed to blunt the full-on disaster of Obamacare’s roll-out by cluttering truly popular demands for reductions in spending and debt with a laundry list of demands about defunding and/or delaying health care and other issues (such as approving the XL Keystone Pipeline).
Had the GOP focused on strictly fiscal matters, they not only might have gotten a clean CR at current spending levels and a blessedly dirty debt deal, they might have provided space for a true grassroots movement to delay Obamacare.
Instead, here we are, with a Congress that no one can stand, a president whose numbers are slumping, and a botched health-care reform whose worst days are ahead of it and whose online debut inspires about as much confidence in the future of America as flooz.com did back in the day.