On Obamacare, president contrite but resolute



It was a necessary retreat, but President Obama made clear Thursday that his bottom line remains unchanged: “I’m not going to walk away from 40 million people who have the chance to get health insurance for the first time.”

The president’s pledge should be the nation’s bottom line as well. It came as Obama surrendered to overwhelming pressure, much of it from fellow Democrats, and allowed individuals to keep their bare-bones insurance policies that do not meet the Affordable Care Act’s standards – at least for a year. The change was meant to correct an imbalance that cannot long be tolerated: More people are being annoyed and inconvenienced by the new law than are being helped.

It should be the other way around, and Obama accepted the blame. “There have been times where I thought we were kind of, you know, slapped around a little bit unjustly,” he said. “This one’s deserved, all right? It’s on us.”

The only semi-dodge was when Obama apologized, kind of, for his repeated assertion that Americans who were satisfied with the health insurance coverage they already have would be able to keep it. “There is no doubt that the way I put that forward, unequivocally, ended up not being accurate,” he said.

“Ended up not being accurate” is a phrase I might try the next time I have to correct an erroneous fact or a misattributed quotation. I doubt my editors will let me get away with it.

Overall, however, Obama was as contrite as I’ve ever seen him, and also as resolute. We screwed up, he effectively said, but we’re not backing down.

The president went out of his way to apologize to Democrats in Congress who voted for the Affordable Care Act, told their constituents how great it would be and now find themselves in political peril. “I feel deeply responsible for making it harder for them, rather than easier for them, to continue to promote the core values that I think led them to support this thing in the first place, “Obama said.

Some House and Senate Democrats might still feel the need to go on record as voting to allow people to keep the individual insurance policies they have, even if the coverage they have is substandard. But Obama probably eliminated any threat that much more sweeping Republican legislation, sponsored in the House by Rep. Fred Upton of Michigan, would pass both chambers and force the president to exercise his veto.

The GOP has made clear that it wants to destroy Obamacare, not fix it. Obama’s move Thursday is an inelegant solution that keeps the Affordable Care Act intact – and suggests that the program will have not just a rocky first month but a bumpy first year.

Obama took full responsibility for the many failings of the HealthCare.gov website, which has made it absurdly difficult to shop and buy on the new federal health insurance exchanges. Despite accepting blame, he said he had been unaware of how bad things would be until after the launch.

“I was not informed directly that the website would not be working,” Obama said. “I’m accused of a lot of things, but I don’t think I’m stupid enough to go around saying this is going to be like shopping on Amazon … if I thought that it wasn’t going to work.”

Largely because of the impenetrable website, only 106,185 people actually signed up for insurance through the federal and state exchanges in October. Officials had hoped that at least 500,000 would sign up during the program’s first month. Even if HealthCare.gov is fixed – or at least duct-taped into basic functionality – by Nov. 30, as the administration promises, the painfully slow start may mean that first-year enrollment won’t reach projected levels.

Obama’s keep-your-insurance concession may further depress enrollment, as some people choose to stick with their cheap, no-frills coverage rather than upgrade to more comprehensive care through the exchanges. Lobbyists for the insurance industry warned Thursday that if fewer young, healthy adults buy policies than originally projected, rates will have to increase for everyone else.

So this tempest-tossed launch could be just prelude to a turbulent flight. In the long term or even the medium term, however, I’m much less pessimistic than a lot of folks seem to be.

Transforming the health care system was never going to be easy. Obamacare realigns the incentives in the system toward wider coverage, cheaper insurance, regular doctor visits and preventive care. Given a bit of time and space, I’m confident it will work.

Those who say otherwise are going to, um, turn out not being accurate.

© 2013, Washington Post Writers Group

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