AFFORDABLE CARE ACT

‘Obamacare’ here to stay, despite rollout problems

 
 
REID
REID

joy-ann.reid@nbcuni.com

As the media crisis over Obamacare unfolded and untold thousands of Americans were unable to log onto Healthcare.gov — and more important, potentially hundreds of reporters were unable to pretend to sign up for healthcare — a bizarre routine took hold in Washington.

Republicans, who almost to a person believe there should be no subsidized health insurance, took turns, in front of TV cameras and in committee hearings, denouncing the delays in Americans being able to obtain subsidized health insurance.

Worse, declared the opposition party, Americans who currently purchase insurance in the individual market, which anyone who has used these products understands to be the most expensive and least durable form of health insurance, might not be able to keep their cruddy plans, because those plans don’t offer such liberty killers as free health screenings, an end to payout caps or a prohibition on barring people with pre-existing conditions. Shame on the Obama administration for offering those people generous federal subsidies to switch to a plan that gives them these things without a monstrous deductible.

Funny that none of the conservative umbrage has been reserved for the 8 million or so Americans who really won’t be able to access the Affordable Care Act, not because of a glitchy website, but because their own governors and legislators, all Republican, refuse to accept the federally funded expansion of Medicaid. Perhaps that particular moral outrage could get some play if a few reporters could fake sign up for the state-based program for the working poor.

Dave Camp, the Ways and Means Committee chair, used Tuesday’s grilling of Medicare administrator Marilyn Tavenner to engage in a little “truthiness,” declaring that, “While the (ACA website) can eventually be fixed, the widespread problems with Obamacare cannot.”

And therein lies the rub.

Republicans understand that, like every version of Windows, my junky cable service or the umpteenth series of the iPhone, the “Obamacare” website will eventually work as it’s supposed to, or at least as well as any 1-800-FLOWERS on Mother’s Day, which has become the GOP’s gold standard for the way the interwebs should be. Their problem is with the existence of the law itself, which they have tried with state lawsuits that went all the way to the Supreme Court, 44 useless votes in the House of Representatives and a nasty government shutdown to overturn.

All of those efforts failed. The real fear among Republicans, who rammed through their own entitlements expansion, Medicare Part D, on a party-line vote, followed by a very glitchy rollout, is that — like Medicare (Part D included) and Social Security — Obamacare is here to stay. Of course, Part D was a pander to elderly voters, while the ACA disproportionately helps younger and browner Americans.

Paul Ryan has come closest to the bottom line, explaining the conservative fear that once people, and states, get used to the federal subsidies in healthcare, it will be impossible for future Congresses to take them away. Subsidized individual health insurance will come to be seen as a true “entitlement,” offering budget-whacking conservatives fewer items to whack.

And such notions as the right to be insured regardless of pre-existing condition; free mammograms and other preventive screenings; the ability of young people to remain on their parents’ insurance up to age 26; and the requirement that insurance companies spend 80 percent of their budgets on healthcare will become embedded in the public consciousness. That will make it all but impossible for those benefits to be withdrawn, even by the powerful will of the market.

According to the best estimates of the Department of Health and Human Services, more than 700,000 Americans have signed up for health coverage, though it’s unknown how many have been enrolled.

Kathleen Sebelius, who runs HHS, apologized to the country on Wednesday, and the administration deserves no high fives for the IT crack-up. But working with a budget that was too small and a self-imposed Oct. 1 deadline, the contractor and agency-made problems are not exactly unprecedented.

As Rep. Camp said, eventually the site will be fixed. The state-run exchanges are chugging along. And despite the ongoing desperation of the opposition party, Obamacare will still be around.

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