Can it be revived?

Obama struggles to save his cherished health law.
Associated Press
Nov 16, 2013

President Barack Obama's health care law risks coming unglued because of his administration's bungles and his own inflated promises.

To avoid that fate, Obama needs breakthroughs on three fronts: the cancellations mess, technology troubles and a crisis in confidence among his own supporters.

Working in his favor are pent-up demands for the program's benefits and an unlikely collaborator in the insurance industry.

But even after Obama gets the enrollment website working, count on new controversies. On the horizon is the law's potential impact on job-based insurance. Its mandate that larger employers offer coverage will take effect in 2015.

For now, odds still favor the Affordable Care Act's survival. But after making it through the Supreme Court, a presidential election, numerous congressional repeal votes and a government shutdown, the law has yet to win broad acceptance.

"There's been nothing normal about this law from the start," said Larry Levitt, an insurance expert with the nonpartisan Kaiser Family Foundation. "There's been no period of smooth sailing."

Other government mandates have taken root in American culture after initial resistance. It may be a simplistic comparison, but most people automatically fasten their seat belts nowadays when they get in the car. Few question government-required safety features such as air bags, even if those add to vehicle costs.

Levitt says the ACA may yet have that kind of influence on how health insurance is viewed. "An expectation that everybody should have health insurance is now a topic of conversation in families," he says.

That conversation was interrupted by news that the HealthCare.gov website didn't work and that people with coverage were getting cancellation notices despite Obama's promise that you can keep your insurance.

Obama maneuvered this past week to extricate Democrats from the cancellations fallout.

The president offered a one-year extension to more than 4.2 million people whose current individual policies are being canceled by insurers to make way for more comprehensive coverage under the law. This move by the White House was intended to smooth a disruption for which his administration completely failed to plan.

But it also invited unintended consequences, showing how easily the law's complicated framework can start to come loose.

State insurance commissioners warned that the president's solution would undermine a central goal of the law, the creation of one big insurance pool in each state for people who don't have access to coverage on their jobs. Fracturing that market could lead to higher future premiums for people buying coverage through the law's new insurance exchanges, which offer government-subsidized private insurance.

That Obama is willing to take such a gamble could make it harder for him to beat back demands for other changes down the line.

On the cancellations front, the president seems unlikely to break through. He may yet battle to a political draw.

Obama realizes it's on him to try to turn things around, and quickly. In the first couple of weeks after the website debacle, Obama played the sidelines role of "Reassurer-in-Chief." Now he's on the field, trying to redeem himself.

"I'm somebody who, if I fumbled the ball, I'm going to wait until I get the next play, and then I'm going to try to run as hard as I can and do right by the team," Obama said Thursday at a news conference.

Making sure the website is running a lot better by the end of the month may be his best chance for a game-changing play.

Although only 26,794 people signed up in health plans through the federal site the first month of open enrollment, 993,635 applied for coverage and were waiting to finalize decisions. For many it took hours of persistence, dealing with frozen screens and error messages. When states running their own sites are included, a total of 1.5 million individuals have applied.

The law's supporters believe that's evidence of pent-up demand, and so far the insurance industry agrees. Public criticism of the administration by industry leaders has been minimal, even though insurers also have been on the receiving end of the website problems. Compounding the lower-than-expected sign-ups, much of the customer data they got was incomplete, duplicative or garbled.

Insurers, eager for the new business expanded coverage would bring, are pressing the administration to clear a route for them to sign up customers directly. Such workarounds may put Obama back on track toward his goal of signing up 7 million people for 2014. Medicaid expansion, the other arm of the law's push to cover the uninsured, signed up 396,000 people last month, a promising start.

With the website troubles, a national effort to promote insurance enrollments has been dialed down. Groups ranging from liberal activists and civic clubs to health promoters were mobilized and waiting. But there was little they could do. Advertising campaigns have been postponed. As the year-end holidays approach, both volunteers and the people they would be trying to reach have other priorities.

Whether enthusiasm among the rank-and-file supporters of the law will come surging back is one of the big unknowns for a president who has acknowledged the need to restore his credibility on health care.

"I think people have lost confidence in the ability of this working," said Kansas Insurance Commissioner Sandy Praeger. "And we've still got the anti-Obamacare folks out there taking full advantage." Praeger is a Republican who believes her state should have helped implement the law.

Skittishness among supporters was evident in the 39 House Democrats who Friday bolted their party to vote for Republican legislation on cancellations, ignoring Obama's veto threat.

Politics is not the only consideration.

The people who are signing up now are likely to be those with unmet medical needs. Younger, healthier customers probably don't see much reason to spend their time tangling with the website. To hold down costs, the law aims for a mix that includes a hefty proportion of younger enrollees whose medical expenses are low.

"Everybody said the website would be up and running the first day," said Praeger. "The longer it takes, the more people are going to question whether this is going to work."

 

Comments

Dinghy Gal

Let's hope not

Darwin's choice

http://www.foxnews.com/politics/...

Hmmmm......doing what Cruz wanted all along, silly democrats.

concernedtruth

I refuse to sign up for this communistic, socialistic extortion that our "fearless leader" (said with sarcasm)has thrust on us. FROM MY COLD DEAD HANDS!! I will never back a government that forces it's legal citizens to purchase something they can't afford, don't want or don't want to change what they have. I will not be a part of Nazi type of tactics.

The Big Dog's back

Yep, let everyone else pay for your medical bills.

The Hero Zone's picture
The Hero Zone

By whatever logic you are using to determine that "we" are paying for his bills, then it sounds like we actually have had before the ACA the single-payer system that I believe you prefer we have. Nobody turned away, bills paid in full even if by "others". Am I wrong? Where, why?

Pete

DailyKOS or one of the other Progressive websites must have given him the idea he somehow pays for other's medical bills.

He has been throwing that around lately quite a bit.

The Big Dog's back

Who pays then sappy? People getting Medicare paid into it.

The Hero Zone's picture
The Hero Zone

I am going to presume that you believe the taxpayer "pays" for unpaid bills because the government isn't getting every penny of taxable income from a facility that it thinks it can as the losses are deducted before taxes.

In other words, if a hospital conducts $10M in business but has a 5% (industry statistic) write-off for nonpayment, the government only collects taxes on $9.5M. So, presumably according to you, the taxpayer "paid" for $500k by some stretch as it was money the government could have maybe possibly confiscated from the hospital but didn't.

Is this right?

In that case, we need to fix the broken tax system to squeeze every penny out of someone because all the perfectly-legal deductibles are actually cruel "loopholes". It is unfair that our money is considered ours first. Government should collect on the gross first then we are allowed to keep whatever is left as a gift from the government. Hmm? Our predicted maximums should always be taxed regardless of circumstances, then we get the crumbs? But oh what patriotic crumbs they are! Knowing you lived up to the supposition and expectation of someone you will never meet, was never elected, and has no care for your personal life circumstances.

We need to tax families who have a stay at home parent more. After all, if a working wife takes home $50,000 but gives half of it to the stay at home dad, clearly the TOTAL income of the household is actually $75,000 and they should be taxed accordingly. Yes?

The government is paying for that $25,000 subsidy to the husband. YOU! You are paying for a tax-dodging layabout! All because these "middle-class" people are abusing loopholes in the system that allow them a life of excess. I mean we're talking $75,000 here! Since the government should be able to tax the full $75,000 but is only getting it off the $50,000 we're on the hook for all that money. They probably waste it, too, on whatever it is rich people do. Yes?

Is this your logic? Is the government due taxes on what it perceives your gross is (or worse, "should be")? If someone steals from my store and I deduct the loss, does that mean YOU are paying to support my store? Or actually did I just eat it up front, wrote it off, and continued business of producing many, many more goods, services, and taxable events than not?

mikesee

Doggie when someone receives a subsidy to help them pay their insurance then that means others are paying their bills.

Mommy25

"let everyone else pay for your medical bills" big dog, is EXACTLY what obamacare is ALL about. Funny that IF obamacare is Sooooo great that obama himself doesn't want it for his own daughters.

dontknowmuch

Big Dog isn't smart enough to put 2 and 2 together and realize others are footing the bill so that others can have insurance

The Big Dog's back

Write your Repub Senators and Congressmen for legislation that makes it mandatory for them too.

Maggdi

There's no further point that needs to be made:
Our betters are forcing we the sheeple to take something they themselves are not willing to have.
What is this equal protection you speak of?

A Young Adult's...

Only 3 more years of this clown. Seems like an eternity.

coasterfan

Of course it can be revived. The website will get fixed. Much as Republicans would wish that it won't succeed, it will.

Fromthe419

How do they put the toothpaste back in the tube?... a metaphor, I know. The only way this works is if everyone not having employer backed health care plans is to put them in the exchange. If you allow some to "grandfather" they are diluting the pool and the premiums will go up. I have one of those so called inferior policies right now, I might keep it or I might not. I want to see what the exchange has to offer, but when I go to the website, all I see is $387 per month for an individual and no mention of deductible, what is covered etc. All I see is it is a Gold Plan with no mention of what it is. They need to get this fixed, so I can see what my options are once my current plan is done away with this year or next year.

SamAdams

From what I've been able to get from the Website, your options go from bad to worse. At the minimum, your deductible is some $6,500 per year, and your copay is 40%. Note, too, that one of the "executive order delays" under Obamacare is the maximum out-of-pocket expenses in 2014! And even with such poor coverage, the premiums are high. NOTE: On the low end of the options, there are no subsidies whether you're eligible or not. Cheer up, though: It'll include free birth control!

In truth, I wouldn't take the estimated premium amounts seriously right now. As of a couple of weeks ago, the estimated premiums were frequently off by as much as 100%.

Contango

Re: "Of course it can be revived."

The odds of it potentially "succeeding" will improve with your financial support.

You're on your spouse's OH taxpayer guaranteed STRS health plan aren't you?

Well then drop your old "substandard" employer based health ins. and buy a "new & improved" individual policy on the exchanges.

Put your $ where your mouth is.

So why isn't the "Obama" in Obam☭are signing up and setting an example????

Contango

"Obamacare: Memo reveals health care adviser warned W.H. was losing control 3 years ago":

http://www.cbsnews.com/8301-5052...

Pres. Obama, 11/14/13:

"I was not informed directly that the website would not be working as -- the way it was supposed to,"

Has I been informed, I wouldn't be going out saying, boy, this is going to be great.

You know, I'm accused of a lot of things, but I don't think I'm stupid enough to go around saying, this is going to be like shopping on Amazon or Travelocity, a week before the website opens, if I thought that it wasn't going to work."

"I don't think I'm stupid enough,"?

Why, does he wish that he was more "stupid"?

http://www.washingtonpost.com/po...

FORWARD CHOOM GANG!

Dr. Information

This thing will not survive. It will be repealed one day because the people HATE this thing. Its job killing, people killing and has a net negative effect overall.

The polls are out:

Obama is a failure across the lines. A large section of people who had his back, even when wrong, from day one are seeing the real failure he is and starting to wake up.

Contango

In the 2014 election, more Dem seats are in play in the Senate than are Repub.

21 to 14.

Three: MT, WV and SD, currently held by Dems are leaning Repub.

The Dems may run, but they can't hide. :)

http://online.wsj.com/news/artic...

The Big Dog's back

Other than right wingers committing suicide because they hate Obama so much, who has it killed?

Darkhorse

The president lied about Obamacare so he could win the election. If he told the truth, you would not have voted for him. It takes being hit financially to wake up and smell the coffee. Did people think insurance was going to be free? The middle class is getting hit hard because we are picking up the shortfalls. the country will suffer tremendously if the program isn't stopped.

The Big Dog's back

So why aren't the rich picking up the "shortfalls"? I'm sure if the Repubs proposed that it would have overwhelming support from Dems.

Contango

Little reported:

Small co. group insurance plans are also being adversely affected.

(The majority of Americans are employed by sm. business with fewer than 50-100 employees)

"Some small-group plans are also expected to cost more under the law because starting in January insurers will be prohibited from setting premiums for such policies based on a firm's industry or the health or gender of its staff."

"Brokers say the change will drive up premiums for companies with lots of young, healthy workers, while moderating rate increases for firms with older and sicker workers."

http://online.wsj.com/news/artic...

The Big Dog's back

Other than rupert murdoch, who's your source?

Contango

The source doesn't change the FACTS you PDB.

The Big Dog's back

Yes it does. Fox and wsj are fact free zones.

Contango

Re: "Fox and wsj are fact free zones."

Only in your tiny canine brain you PDB.

"Small-business insurers warn that Obamacare requires higher premiums in 2014":

http://www.cleveland.com/open/in...

https://www.healthcare.gov/what-...

Contango

Re: "shizzle"

"It has two meanings, 'Sure' and 'Sh*t'. It all depends on the way you say it."

"Word most often abused horribly by inexperienced suburban white douche-bags who wish to give themselves some falsified counterfeit form of street-cred.

Also used by the oreo cookies who stoop low enough to keep the company of these pathetic weasels."

http://www.urbandictionary.com/d...

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