Friday, November 1, 2013

Nightmare at 1600 Pennsylvania Avenue

Okay, it has now been one month since the Affordable Care Act went live and I thought I would share my nickel's worth on both the website rollout and the growing concern over the plethora of policy cancellations that have provided the law's opponents yet new ammunition with which to attack it.

Let's start with the website. Suffice to say it has been a clusterfuck. Regardless of the hows and the whys, this much is certain: the Administration apparently was warned some months ago that there were problems with the software. It's hard to imagine that anyone at HHS could've thought they were prepared for what was expected to be a high turnout. Even if you allow for the fact that a lot of new software rollouts are rocky - the rollout of Medicare Part D in '05 was an unmitigated disaster - somebody high up should've been on top of this. The fact that the state websites, where the exchanges were set up, are doing quite well, proves that this wasn't an impossible task. Somebody clearly screwed the pooch.

The good news is that this is fixable. The Administration has said it will get the website up and running properly by the end of November. If that indeed happens, most of this will blow over by the middle of the winter.

The bad news is that many people who wanted to sign up for medical coverage still haven't been able to, and that could be a problem, primarily because of the  individual mandate, which kicks in March 31, 2014. Already there are calls to delay it, some even from Democrats. Given that we are looking at a two-month delay in fixing the website, a one month delay on the mandate would not be too much to ask. Delaying it any further would be kowtowing to the wingnuts on the Right who never wanted the law in the first place and have been doing everything possible to derail it.

And speaking of the wingnuts, how typical that the fiercest opponents of this law are now hopping mad that it isn't working properly. Disingenuous would be a word in a half for this bunch. Fortunately, most of the public isn't buying the dog and pony show. GOP poll numbers continue to plummet.

But now we come to the second and most important issue: the canceled policies that are starting to mount. The President was quoted many times over the last three years that if you liked your current plan, you could keep it. As we speak hundreds of thousands of privately insured people have been notified that their existing policies will be canceled as of the end of the year. While none of these policies are employer or government based, they do represent a sizable amount.

The problem comes down to the fact that the ACA requires all healthcare insurers to provide ostensibly the same benefits to all their policy holders. Those policies that don't measure up and were issued prior to the law's implementation were allowed to be grandfathered in. Supposedly that was the end of the story. However, HHS added additional language that said "that if any part of a policy was significantly changed since that date -- the deductible, co-pay, or benefits, for example -- the policy would not be grandfathered."

Oops.

It is estimated that as many as 80 percent of these individual policies will be canceled and that has naturally prompted outrage, some legitimate, most illegitimate. As far as the former goes, yes, some of these people will end up paying more for their coverage. But the fact is that the plans they had weren't all that good to begin with. Paying $54 per month for healthcare coverage that doesn't provide for hospitalization or outpatient care or co-pays for doctor visits, really isn't coverage at all; it's like paying for a car that doesn't have an engine.

Still, the Administration should have come clean and said that plans that don't measure up to certain standards will not be renewed. Yes, it would've been politically difficult to do, but the whole idea for passing the law in the first place was to eliminate the nightmare of people who were either under insured or not insured at all putting a strain on the healthcare system. What better way to make your case to the American people then to have an adult conversation about what constitutes adequate and inadequate insurance.

But then we come the real crux of the matter: communication breakdown. If I've said it once, I've said it at least a hundred times. President Obama's biggest problem has been an innate inability to effectively draw a narrative that explains where he is going and why. It is a fact that with the launch of the website just days away, most Americans still didn't know what was in the healthcare law. In fact one of the more sadly amusing story lines that developed - to the delight of a particular late-night comedian - was that some people apparently didn't know that the Affordable Care Act and Obamacare were the same law.  All kidding aside, that was inexcusable.

Had this President simply been more out in front of his signature piece of legislation, it might've preempted some if not all of the attacks against it, almost all of which have been proven false. It would most assuredly have stopped idiots like Tennessee representative Marsha Blackburn from suggesting that people who buy insurance that adequately covers them are being forced to buy Ferraris. A Ferrari? How about a Honda Civic?

Now the Administration is on the defensive and Obama is hitting the road doing damage control. None of this was necessary. Had the HHS or the President himself simply taken the time to explain what was in the healthcare law, we wouldn't be at this stage now with Republicans holding fake hearings expressing fake outrage over fake issues concerning a law they detested from day one.

Of all the wounds, it is the self inflicted ones that hurt the most.

Links: http://investigations.nbcnews.com/_news/2013/10/28/21213547-obama-admin-knew-millions-could-not-keep-their-health-insurance?lite
http://www.mediaite.com/tv/fox-news-greta-van-susteren-out-journalisms-cbs-news-on-florida-womans-junk-insurance/

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