Obamacare debacle fuels another race to the bottom

Incompetence, deception dominate first impressions of health law mandate

November 04, 2013|Dan Rodricks

The more I hear from our beleaguered Explainer-in-Chief, his apologists and the strident opponents of Obamacare on the far right — pretty much the whole lot of American noisemakers these days — the more I sense the bottom approaching again.

Look at where we are. In the NBC News/Wall Street Journal poll released last week, seven out of 10 Americans said they believe the nation is "on the wrong track." Sixty-three percent considered the U.S. to be "in a state of decline."

And for the first time in the 25-year history of that poll, the public's negative rating of Republican leadership topped 50 percent; it was at 53 percent last week, with an approval rating of only 22 points. That's completely understandable, given the recent budget fiasco and GOP-orchestrated government shutdown. Seventy-five percent of Americans think Congress contributes to problems instead of solving them.

But President Barack Obama is in a tumble, too. His approval rating fell to 42 percent, its lowest yet. Fifty-one percent of Americans disapprove of his handling of the job.

Just three weeks ago, the president was looking much better – and five points higher in polls. Coming off an uncharacteristically strong showing against the tea party extremists who forced the shutdown and our dalliance with default, Obama now looks like the kind of shaky CEO who gets the boot from stockholders.

It's all because of Obamacare — not because it's a bad idea, but because it isn't exactly what Obama said it would be and because its rollout has been miffed. It's really the only thing Obama had to get right in his presidency, and so far the law's central measure, the individual mandate, is a debacle. (That's his health secretary's word — and mine.)

The bit about all people with health insurance getting to keep theirs' – stated and repeated by Obama several times – turns out to not be true.

Cancellation notices have been going to Americans who pay for insurance policies that are, shall we say, substandard. (As Vinnie DeMarco, president of the Maryland Citizens Health Initiative, said the other day: "They have virtually no insurance.")

The new federal law says everyone must have insurance that meets certain standards.

That totally makes sense. But it's not what Obama said, and it's not what Democrat senators and representatives repeated throughout the Obamacare campaign. Worse, it means some people — those who earn too much to be eligible for a federal subsidy — will pay more for insurance than they're paying now.

Even people who voted for Obama and supported Obamacare didn't see this coming. They listened to the president when he said 85 percent of us — those who already have health insurance — would not even be affected by the new law, except in a good way: We'd no longer be carrying the millions of uninsured through the premiums we pay.

So we have a troubling bait-and-switch narrative twinned with a disastrous roll-out of the Healthcare.gov web site. What a mess. And what a dream for the told-you-so Republicans who get to point out Obamacare's flaws after having spent years trying to cripple it.

Obamacare might some day become a solid piece of the nation's social safety apparatus, but you only get one chance to make a first impression, and the president blew it. Obamacare wasn't ready to go and it wasn't all that the president said it was.

When this health care odyssey began, Obama declared a single-payer system ("Medicare for all") a non-starter, then turned over the design and construction of the Patient Protection and Affordable Care Act to members of Congress, a co-opted political class beholden to special interests. So we have for-profit companies still involved in providing health insurance, and a public-private system that is far more complicated and cumbersome than it should have been.

President Obama is a good explainer; he can be powerfully persuasive. But all the smart, nuanced explanations of his signature domestic achievement — including his speech in Boston last week — cannot neutralize those twin narratives of deception and incompetence.

He's given a couple of Obamacare speeches that I'm sure his writers think were rational, comprehensible and convincing. But those speeches have been largely reactive and defensive instead of proactive, with a clear, strong message. Obama should have addressed the nation from the Oval Office with a couple of simple charts, explaining how the law is supposed to work and how it will benefit the nation.

Even then, however, he would have been undercut by the fiasco of Healthcare.gov and all the cancellation notices.

Considering the stakes, the high-profile nature of the PPACA and the long history of efforts to establish national health insurance, Obama might be presiding over American progressivism's most damaging, self-inflicted blow. At a time when increasingly extremist and irrelevant Republicans should be eating his dust, Obama has to eat some crow.

It's not a pretty picture – deceptive advertising and incompetence from the White House and obsessive obstructionism from House Republicans at a time when the nation should be recovering from recession, moving forward and striving for that which makes us exceptional. Instead, look at where we are.

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