Incompetence, politics, and delays frustrate advocates of health care reform.
by Ron Fournier
It’s getting difficult and slinking toward impossible to defend the Affordable Care Act. The latest blow to Democratic candidates, liberal activists, and naïve columnists like me came Monday from the White House, which announced yet another delay in the Obamacare implementation.
For the second time in a year, certain businesses were given more time before being forced to offer health insurance to most of their full-time workers. Employers with 50 to 99 workers were given until 2016 to comply, two years longer than required by law. During a yearlong grace period, larger companies will be required to insure fewer employees than spelled out in the law.
Not coincidentally, the delays punt implementation beyond congressional elections in November, which raises the first problem with defending Obamacare: The White House has politicized its signature policy.
The win-at-all-cost mentality helped create a culture in which a partisan-line vote was deemed sufficient for passing transcendent legislation. It spurred advisers to develop a dishonest talking point—”If you like your health plan, you’ll be able to keep your health plan.” And political expediency led Obama to repeat the line, over and over and over again, when he knew, or should have known, it was false.
Defending the ACA became painfully harder when online insurance markets were launched from a multi-million-dollar website that didn’t work, when autopsies on the administration’s actions revealed an epidemic of incompetence that began in the Oval Office and ended with no accountability.
Then officials started fudging numbers and massaging facts to promote implementation, nothing illegal or even extraordinary for this era of spin. But they did more damage to the credibility of ACA advocates.
Finally, there are the ACA rule changes—at least a dozen major adjustments, without congressional approval. J. Mark Iwry, deputy assistant Treasury secretary for health policy, said the administration has broad “authority to grant transition relief” under a section of the Internal Revenue Code that directs the Treasury secretary to “prescribe all needful rules and regulations for the enforcement” of tax obligations, according to The New York Times.
Yes, Obamacare is a tax.
Advocates for a strong executive branch, including me, have given the White House a pass on its rule-making authority, because implementing such a complicated law requires flexibility. But the law may be getting stretched to the point of breaking. Think of the ACA as a game of Jenga: Adjust one piece and the rest are affected; adjust too many and it falls.
If not illegal, the changes are fueling suspicion among Obama-loathing conservatives, and confusion among the rest of us. Even the law’s most fervent supporters are frustrated.
Ron Pollack, executive director of the consumer lobby Families USA and an ally of the White House, told The Washington Post he was “very surprised” by the latest delays. For workers at large companies that don’t provide coverage, he said, “It’s very unfortunate … that they don’t have a guarantee it will be extended to them for quite some time.”
Put me in the frustrated category. I want the ACA to work because I want health insurance provided to the millions without it, for both the moral and economic benefits. I want the ACA to work because, as Charles Lane wrote for The Washington Post, the link between work and insurance needs to be broken. I want the ACA to work because the GOP has not offered a serious alternative that can pass Congress.
Unfortunately, the president and his team are making their good intentions almost indefensible.
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Ron Fournier is the Senior Political Columnist and Editorial Director of the National Journal.