Party leaders in Congress and in the Trump administration held up the American Healthcare Act as the GOP’s long-awaited deliverance on its promise to repeal and replace the Affordable Care Act with “patient-centered” market reforms, hoping to pass the bill through the House and Senate within a matter of weeks. But by Tuesday evening, it wasn’t clear whether the legislation would ever make it to a floor vote, and it was far easier to find lawmakers and organizations who were against the bill than it was to find those in favor of it.Republicans in Congress were increasingly looking to President Trump to help lift their flagging legislation.
WikiLeaks published a stunning memo, dated November 23, 2015, to presidential candidate Hillary Clinton and John Podesta, the chairman of her campaign, from Chris Jennings, the former Deputy Assistant to President Obama for Health Policy, about serious problems with the Affordable Care Act (ACA). Though intended only for internal viewing, the document is now in the public domain. Similar to the Jonathan Gruber statement of how policymakers intentionally mischaracterized key ACA provisions because of the “stupidity of the American voter,” this memo shows how ACA supporters’ public optimism contrasts with private concern about the law and a need to change course. According to Jennings, “the health insurer and enrollee participation issues in the exchanges are, at best, disconcerting. There are also adverse risk selection and health plan payment issues that are equally troubling and merit scrutiny.”
Jonathan Gruber’s attempt at contrition before the House Oversight & Government Reform Committee might have been convincing had he not lied again. Gruber began his testimony trying to explain away his controversial remarks that have come to light in recent months, but he used deception to do so.Gruber’s actions are part and parcel of how the Obama administration has handled Obamacare. Deceit is routinely employed to reassure the public that the law is a success.
However, it is Barack Obama who holds the modern record for overall losses, at least through 2014. President Obama has presided over two devastating midterms for his party. From 2008 to the present, Democrats in the Obama era have racked up net forfeitures of 11 governorships, 13 Senate seats, 69 House seats, 913 state legislative seats, and 30 state legislative chambers. In the latter three categories, Obama has doubled (or more) the average two-term presidential loss from Truman through Bush.
It may well be that Obama can moderate these totals in 2016 by helping Democrats in a larger-turnout White House year. Still, Democrats would have to fare exceptionally well in the next round of sub-presidential races for Obama to escape the cellar.
Gruber-gate is important for a few reasons besides the normal political “gotcha” game. First, it reminds us that Obamacare’s losers will remain a vital part of the repeal constituency. The mobilization of such people was essential to rolling back the Medicare catastrophic coverage expansion of the 1980s, one of the most prominent examples of a broad-based entitlement being repealed in the post–New Deal era.
Second, it is a fitting window into how the technocrats view the masses. You might have liked the health plan you already had, but Jonathan Gruber knows it was bare-boned and terrible. The liberals truly are the best and the brightest.
Now Gruber is saying he misspoke and his allies are adamant that any text of their law that might lead to unfavorable results is simply a typo. Move along, there’s nothing to see here.
Consider health care. If any issue might suggest an Obama vision, this would be it. But what, really, is Obamacare? It is quite unlike Medicare or Social Security. Both programs—despite their shortcomings—are conscientious mixes of policy ideals and political realities, crafted by men with clear visions. Look carefully at both programs, and you can see that vision, not only of what the proper policy is, but how to get it through Congress and build public support.
Obamacare exhibits none of these qualities. It is a bizarre Rube Goldberg contraption with no clear idea at its core. The exchanges are intended to promote competition while the Medicaid expansion doubles down on single payer. It reins in the insurance companies while the risk corridor program shovels billions to them in bailout cash. It expands coverage for prescription drugs for seniors while simultaneously granting drug companies some exceedingly generous rents.It is almost as if it were written with no White House input except, “Get me a bill to sign!”
Former Health and Human Services Secretary Kathleen Sebelius acknowledged Friday that she made mistakes leading up to the rollout of the Affordable Care Act, worrying too much about whether there’d be a market for Obamacare and spending “too little time clearly on the technology side.”“I sure made some mistakes along the way in terms of focusing on some things and not on others,” she said at the Aspen Ideas Festival. Instead of confirming what she was being told about HealthCare.gov’s readiness “was actually accurate and getting enough eyes and ears on that,” she said she concentrated on the insurers, consumers and regulators who needed to come together in the health exchanges.