Bureaucrats bungle implementation while health care costs skyrocket.
As a rule, I avoid the weekly news magazines. They are filled with bad fiction disguised as “reporting,” and if I really feel the need to read mediocre prose I can always rely on the work of America’s growing horde of creative-writing professors. Nonetheless, I recently stumbled across a post in Time’s Swampland blog titled, “Obamacare Incompetence,” and succumbed to morbid curiosity. It seems that Joe Klein, a usually reliable Democrat hack, is deeply unhappy with the slow and clumsy implementation of the “Affordable Care Act.”
Klein’s post focuses primarily on the implosion of Obamacare’s exchanges. Pointing out that the President’s apparatchiks squandered three full years during which they should have been hard at work preparing for the advent of these insurance “marketplaces,” Klein laments their failure to do so with the following piece of Solomonic wisdom: “This is a really bad sign.” Indeed it is. And Klein isn’t the only advocate of Obamacare to finally notice that this hopelessly Byzantine health care “reform” law is an implementation nightmare.
Even the Secretary of Health & Human Services (HHS) has admitted as much. But, whereas Klein correctly assigns responsibility to the President, Commissar Sebelius places the blame on evil Republicans: “It is very difficult when people live in a state where there is a daily declaration, ‘We will not participate in the law.’” Other Democrats have been more candid. Senator Jay Rockefeller, who played an important role in getting the law passed, called Obamacare “so complicated that if it isn’t done right the first time, it will just simply get worse.”
And it most emphatically isn’t getting done right the first time. Not only has the go-live date for the insurance exchanges been pushed back a year, a wide variety of the law’s other key provisions have either been delayed or simply abandoned. The most conspicuous of the latter category was the Community Living Assistance Services and Supports (CLASS) Act. This program was so badly designed that Kathleen Sebelius admitted HHS couldn’t pay for it and one of its own administrators speculated that it might collapse. It was repealed in January.
Another moribund provision of Obamacare is the “Basic Health Plan,” included in the law to give states the flexibility to provide coverage for low-income residents unable to afford employer coverage or qualify for Medicaid. Democrat Senator Maria Cantwell is so frustrated with administration foot dragging on this provision that she has announced her opposition to Obama’s nominee to head the Centers for Medicare & Medicaid Services (CMS), Marilyn Tavenner: “Ms. Tavenner definitely will not have my support.”
Senator Cantwell was also among the thirty-three Democrats who voted with all of the Senate Republicans last month to repeal Obamacare’s job-killing 2.3 percent excise tax on manufacturers and importers of medical devices. This vote was toothless as a practical matter because, as Daniel Horowitz explains, “They know that this is only an amendment to a massive budget bill that will never have the force of law.… If 33 Democrats really supported repeal, they could force Harry Reid to bring it to the floor as a standalone bill.”
Still, the vote was not meaningless. These Democrat Senators know that Obamacare is still profoundly unpopular with the public. Indeed, yet another poll was released in early April showing that only 41 percent of American voters approve of the law and that a mere 15 percent expect it to help them personally. Despite the virtual blackout by the major broadcast media of bad news concerning Obamacare, including the medical device vote, the implementation delays and even the survey just cited, the public understands that the law is already failing.
Even the much-touted Obamacare provision that we were told would eliminate the “pre-existing condition” scourge is proving to be a bust. According the Heritage Foundation, the Obama Administration estimated that 375,000 people would enroll in the pre-existing conditions insurance plan (PCIP). “But as of January 2013, over two-and-a-half years since the plan began, only 107,139 were enrolled—less than 29 percent of original projections.” And yet the program is running out of money, forcing the HHS bureaucrats to suspend enrollment.
It hardly needs saying that this failure, like everything else associated with Obamacare, is incredibly expensive: “In a 2012 report, the Administration conceded that claims’ costs had been 2.5 times greater than they had anticipated.” This is of a piece with the “Affordable Care Act” in general. When Obamacare was first shoved down our throats, we were told that it would cost $898 billion. Now the projected cost is $1.6 trillion. Meanwhile, many of its taxes are now in effect and it is forcing health insurance premiums through the roof.
What we are left with, then, is a big-government vampire that will drain our personal and public coffers without delivering on its most important promises. Where will all this end? To quote Joe Klein again, “One thing is clear: Obamacare will fail if [President Obama] doesn’t start paying more attention to the details of implementation.… And, in a larger sense, the notion of activist government will be in peril.” Here’s hoping that the President continues to focus on his golf game and delegates Obamacare implementation to his creatures.
David Catron is a health care revenue cycle expert who has spent more than twenty years working for and consulting with hospitals and medical practices. He has an MBA from the University of Georgia and blogs at Health Care BS.