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Monday, October 24, 2016

Oct. 14 (Bloomberg) — The drama surrounding the government shutdown and potential debt default almost obscured the rollout of President Barack Obama’s Affordable Care Act. Both champions and critics of the measure should be grateful.

More than 8 million Americans tried to log on to federal or state exchanges, despite concerted efforts by conservatives to dissuade them. Software glitches foiled many of these inquiries and undermined supporters’ claims that the program is ready for prime time.

The confusion also underscored again that this measure is the focus of greater partisan rancor than any major U.S. legislation in recent memory. High emotion often distorts reality. The Oct. 1 rollout was interesting, instructive and not that important. Over the next year or so, there are at least four crucial benchmarks:

Dec. 15: That’s when we will know if the computer glitches have been fixed and whether the administration has adequately promoted the law in preparation for Jan. 1, when coverage of the uninsured begins.

Interested customers will come back often. With the Massachusetts plan — a model for Obamacare — there were an average of three to six inquiries before someone signed up. Young people are patient when awaiting the next iPhone or Hunger Games movie, but if the exchanges don’t eliminate the glitches, some prospective signups will be turned off.

The administration doesn’t have its act together. It has enlisted Chris Jennings, a respected expert, as point policy person. There’s a distance, however, between the White House and the Department of Health and Human Services, and the marketing efforts have been much weaker than some proponents advocated.

Celebrities such as Kerry Washington, John Legend, Katy Perry and the Pittsburgh Steelers have promoted the law. But some of the measure’s backers are calling for a far more elaborate effort involving rock stars, athletes and lots of white-coated doctors and nurses.

April 1: The Congressional Budget Office estimates that 7 million Americans will sign up in the first three months.

Achieving that goal, both sides agree, would be a good marker of early success. Failure would signal major problems. Supporters say more than one-third of the enrollees should be younger people.

A year from now: One bit of very good news is that health care costs have moderated. If that trend holds over the next year, insurance rates, which factor in risks and likely costs, would probably come down.

January 2015: More than half the states aren’t participating in a federally funded expansion of Medicaid for poorer citizens; many of these states aren’t participating in the exchanges, either. For the most part, these are heavily Republican areas, where anything associated with Obama is politically lethal.

Zeke Emanuel, a former top Obama advisor on health care who now is a vice provost at the University of Pennsylvania, said the partisan pressure may subside after the 2014 election. Some of the recalcitrant governors, and some newly elected ones, could change course.

“The money is just too good, and they’re going to look at places like California and Oregon and Colorado and see the results are so much better than in their states,” Emanuel says.

He acknowledges that his brother, Chicago mayor Rahm Emanuel, a former White House chief of staff, fears that this prediction is wrong and that ideology will continue to trump practicality.

The Republican critics are on stronger ground when they reject White House complaints that the Affordable Care Act is a settled issue. No piece of legislation is settled and safe from review, modification or elimination. President Ronald Reagan’s tax cuts and Bill Clinton’s welfare overhaul were reshaped multiple times.

Still, it was a politically frivolous and base-pandering act for House Republicans, who have a less than vigorous schedule anyway, to vote 42 times to repeal the health care law, knowing that would be unacceptable to the Senate or the president.

The Republicans offer few serious alternatives, unless they are responding to political pressures. Consider the politically potent makers of medical devices who have used a plethora of flawed contentions to persuade almost all Republicans (and quite a few Democrats) to try to repeal a small tax levied on their products.

At the same time, Republicans haven’t permitted corrections to some obvious flaws in the initial Obamacare legislation. Remedies of this kind were passed after Medicare was enacted in 1965.

“Obama is taking executive actions that may produce a lot of litigation,” says Joe Califano, who was a top advisor to President Lyndon Johnson when Medicare was passed, “because Republicans won’t allow even simple things to be fixed.”

Some of the claims made by these congressional critics are simply disingenuous, such as the assertion that people with pre-existing conditions are already allowed to keep their coverage so they don’t need Obamacare. That’s true of those who have coverage, but for those with illnesses who aren’t insured, insurance is difficult to get. Even for those who are covered, there’s little to prevent insurance companies from jacking up rates. That will change under Obamacare.

Such benefits, the moderating cost of health care and the surge of interest in the exchanges all augur well for the Affordable Care Act in these early stages. But there’s an ominous offset: The political fiascos with the government shutdown and possible debt default have, as the political right hoped, elevated cynicism about the federal government as a whole. Logic suggests that negative sentiment will also be directed at a huge new federal program such as universal health care.

(Albert R. Hunt is a Bloomberg View columnist.)

Photo: LaDawna’s Pics via Flickr

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Copyright 2013 The National Memo
  • Dominick Vila

    Insinuating that software glitches, caused in part by the large number of uninsured Americans trying to learn more about ACA and interested in joining the exchanges, is something that only resonates in Tea Party rallies.
    I think it is important to note that even though many Republicans are still oppose to the deployment of ACA, the focus shifted to spending reduction, and it is now centered squarely on saving face and being to tell constituents that “we” won.
    ACA is law. It was passed by both chambers in Congress, signed by a President, declared constitutional by the Supreme Court, and was an integral part of the 2012 election. Instead of immature demands, the focus should be on how to make it as efficient and cost effective as possible.

    • lana ward

      LIAR!!!! Not ONE Republican voted for this God awful, middle class destroying bill–AND YOU KNOW IT!!!!!!

      • DennisRL

        I don’t know why I should even bother to respond to someone as ignorant as this but he didn’t say it was passed with bipartisan support only that it was passed in both chambers. Try to pay attention if that’s even possible.

        • lana ward

          The US has the worlds greatest software companies-but NONE were chosen to create Ocare. Instead OHitler chose politically connected contractors and the result is a nightmare. The launch of Ocare didn’t run into “gliches”, it’s an utter failure!! And the American people will be forced to pay the billions of penalties. We will be fined for OHitlers incompetence!! How can he require us to have health insurance when he makes it impossible to buy health insurance–are you paying attention??

          • DennisRL

            you know Lana, as looney as you are, you actually may have hit on one truth. The I.T. people involved in the startup screwed this up royally. There should never be this many problems if you have done your due diligence with testing the system before the startup. On the other hand I just think this is a problem that will eventually get resolved and everything will work as it should. Nothing this complicated starts running smoothly and always has problems. And in a sane world (which I realize you are not a member of), both sides would try to work to fix the problems so that health care costs would go down and everyone would get health care. It sounds so simple. You would think that everyone would want good, cheap health care in which everyone gets it. I don’t understand people like you who only want to tear down and criticize with no idea on how to fix this. Everyone agrees that the health care system is broken and what has happened is that big business and the health care industry sold a bill of goods to people on the right to think that Obamacare is bad and somehow the status quo is just fine. It’s absolutely laughable.

  • Bryan Blake

    Yes, the Obama administration should have had its act together in rolling out the ACA. But both governments and private businesses are both human institutions that act through real, live breathing people. So mistakes and missteps will be had. The ACA benefits every man, woman and child that has or will have insurance. But since our public information system, formerly known as news outlets, are now concentrated as the private property of a few multi-media corporations We The People can only access highly slanted and parsed reporting on current events.

    If the average American is ill informed and cynical it is because the media, in general, has shaped public opinion to fit that mold. All to the benefit of their corporate owners, the rich and ultra-rich.

  • elw

    I worked in health care for over 30 years and have watch and actually helped implement several National health programs over the years on a local level. Everyone of them had glitches to begin with and everyone of them ended up being a success. ACA will be the same, it will be fixed, tweaked, expanded and end up a popular beneficial program like all the others. It is not easy to implement Nationwide programs.

  • howa4x

    Most of the problem is because the red states aren’t setting up the exchanges and the federal govt has to do it. This was supposed to be a state role. Imagine trying to set up a site that would handle 2.8million requests in one day? I don’t even think E-bay could handle that kind of traffic. Republicans are trying to throw every obstacle in front of the ACA and not doing their part is one of them.. Interesting that Mass never had this problem when they set up their state site, and states like calif, and NY are helping people get registered while in Miss and Ala they are not. What will finally happen is the people in the blue states that are behind this law will get everyone registered and the red states will as always lag behind. Then republicans will scream that it is not working in their state and people are without insurance, and we can all laugh.

  • montanabill

    Yes, we need to get this rolled out so we can keep our doctor! Ahhh, not so much. But we need to get this rolled out so we can keep our insurance if we like it! Oh gee, that’s not true either. We really need to get ACA rolled out so everyone will save $2500 on the insurance. Wait, that’s not true either, but I thought it was the ‘Affordable Care Act? Now your telling me it really is going to cost a LOT MORE than my old insurance? No wonder the President wants it called: OBAMACARE. Nothing in it is the truth!

    • omgamike

      Where are your facts to back up your assertions? A big mouth is just that — a big mouth — unless you have facts.

      • lana ward

        Check it out-but not with the MSM. This Ocare is costing WAY more, like 2 and 3 times and more than insurance. It is meant to destroy the middle class, just what Ohitler had planned from the very start. Heil Ohitler!!!!

      • montanabill

        Those ‘facts’ you claim you are missing, are hiding in plain sight.

      • omgamike

        Both of you are so wrong. Two of the states already moving quickly to fully implement the ACA, are already seeing big drops in average premiums per month and overall costs to administer the program. Check your facts. I read two comments yesterday, one from an individual and one from a small business employer. Both were seeing premiums costs that were fifty percent less than what they had been paying. Lana, you are just a troll who is only happy when you are posting insulting comments that have no basis in fact.