WASHINGTON — Obamacare is working.
True, that sentence comes with a large asterisk. It is working in states that have followed the essential design of the Affordable Care Act, particularly in Kentucky, Connecticut, Washington and California. The law was written with states’ rights and state responsibilities in mind. States that created their own health care exchanges — and especially those that did this while also expanding Medicaid coverage — are providing health insurance to tens of thousands of happy customers, in so many cases for the first time.
Those seeking a model for how the law is supposed to operate should look to Kentucky. Governor Steve Beshear, a Democrat in a red state, has embraced with evangelical fervor the cause of covering 640,000 uninsured Kentuckians. Check out the website — yes, a website — for regular updates on how things are going there.
“We’re signing up people at the rate of a thousand a day,” Beshear said in a telephone interview. “It just shows the pent-up demand that’s out there.”
Beshear urges us to keep our eyes on the interests of those the law is intended to serve, our uninsured fellow citizens. “These 640,000 people are not some set of aliens,” he says. “They’re our friends and neighbors … some of them are members of our families.” As for the troubled national website, Beshear offered this: “If I could give unsolicited advice to the critics, and maybe to the media, it’s: Take a deep breath.”
Wise counsel. But there can be no denying the system failure that is a profound embarrassment to the Obama administration and threatens to undermine all the good the law could do, since its enemies will use any excuse to discredit it.
Much is inexplicable about how the administration blew the launch. Everyone involved knew that this is President Obama’s signature achievement. Everyone knew that the repeal crowd would pounce on any difficulty, let alone a massive set of tech problems so easy to mock in an age when everyone has views as to what an online experience should be like. Everyone knew going in that this was a complicated endeavor. It is very hard to understand how the officials in charge could risk ignoring the red flags they apparently saw before the site went live.
Some explanations, however, are obvious. The federal government was not supposed to be running this many insurance exchanges. You might have expected that Republican governors who cherish the prerogatives of the states would, like Beshear, welcome the chance to prove that this free-market approach to providing insurance coverage could thrive.