On Politics On PoliticsOn Politics
Analysis and perspective about what's happening in the political realm.

This Isn't the First Time Obama Ignored Health Care Warnings

ARCHIVES

An eerie familiarity attends the stories of warnings to Obama administration officials that the enormously cumbersome Affordable Care Act was having significant implementation problems and that the website about to be launched was in danger of crashing. The disclosures are a metaphor for the history of this legislation, one that could be subtitled, “Damn the torpedoes, full speed ahead.”

Let me first digress. To hear the debate over the health care law, you’d think that all Americans either love it and fully believe that it is a terrific and long overdue program, or that they absolutely hate it and are convinced it will destroy most businesses and the U.S. economy. Those two views often tend to correspond with whether people consider themselves liberals or conservatives. Polls, however, suggest that public opinion is not that clear-cut, and that many Americans, about a quarter, have a much more nuanced view of Obamacare. Personally, I find myself in that middle group.

Think back to 2009, when health care costs were skyrocketing at an unsustainable level. Such costs were weighing heavily on businesses’ balance sheets and were a major driver of federal budget deficits and the national debt. The economy would have paid a terrible price if health care costs continued to grow at such an explosive pace. While most Americans had some kind of health insurance coverage (either through their employers, individual policies, Medicaid, or Medicare), the uninsured found themselves ignoring medical problems, often developing chronic illnesses and eventually seeking care in hospital emergency rooms, one of the most expensive and inefficient methods of health care anywhere. Sooner or later, something had to give; the issue had to be addressed.

But nothing happens in a vacuum, and as Barack Obama took office, in the immediate aftermath of the financial crisis, the economy was in horrible shape and getting worse. Obama and his large Democratic majorities in the House and Senate first focused on passing a stimulus package to jump-start an economy that seemed on life support. They attempted to do so with a proposal that Republicans insisted was too large and expensive, but one that to me (and I wrote this many times during that period) was not aggressive enough, a view that is now widely accepted by economists, including some who did not think so at the time. Obama’s defenders insist that it was the biggest package they could move through Congress; I would argue that a president with a better relationship with Congress could have gotten much more.

After checking the box with an inadequate stimulus package, with the economy still worsening and polls showing Americans wanting Washington to focus on job creation and stabilizing the economy, the administration and House Democrats tackled climate change, forcing a cap-and-trade bill through the House—at great political cost. All of this was done in spite of the fact that the bill had dim prospects at best in the Senate, where members from fossil-fuel states were almost certain to kill it.

Next, Congress turned to health care reform. House Democrats muscled through a bill in late 2009, in the face of polling data showing that Americans desperately wanted Washington to do something about the economy. Not surprisingly, the initiative immediately proved to be a very heavy lift in the Senate. It became clear that Republicans would oppose it and that the economy was worsening. Several books have since cited a key White House meeting in early August 2009 when the president’s congressional liaison staff delivered a negative assessment of the legislation’s outlook. Obama dismissed the advice, saying, “No, I feel lucky,” and opted to push ahead. That same week, the July unemployment report showed jobless rates at or above 9 percent for the third consecutive month. In retrospect, the decision to plow forward on health care reform probably cost Democrats their House majority.

The rest is history. Democrats pushed the Affordable Care Act through Congress on largely a party-line vote, although by any measure it was a bastardized version of Democratic and Republican principles. The ACA’s substance was not what any reformer had in mind, but what ended up being doable at the time. The public reaction to this enormous and complicated piece of legislation, which chewed up the better part of two years of Washington’s attention, was predictable. Democrats lost 63 House seats and control of the chamber; surrendered six Senate seats, cutting their margin over Republicans by two-thirds; and were beaten in gubernatorial and state legislative races that resulted in the worst redistricting map for Democrats in modern history. Quite a price.

At just about every step, Obama has pushed ahead on health care reform, even when it would have been more practical to put it aside, waiting perhaps until the economy stabilized or until the public was more accepting of the law. He most recently chose to plow ahead when the apparatus to implement the ACA had huge problems. Warnings inside the administration were ignored. If perseverance were the only virtue, the president and congressional Democrats would be the most virtuous people around and assured a place in heaven. But sometimes balance and reality should intervene. They certainly did not here. 

FROM OUR SPONSORS
JOIN THE DISCUSSION
Close [ x ] More from GovExec
 
 

Thank you for subscribing to newsletters from GovExec.com.
We think these reports might interest you:

  • Sponsored by G Suite

    Cross-Agency Teamwork, Anytime and Anywhere

    Dan McCrae, director of IT service delivery division, National Oceanic and Atmospheric Administration (NOAA)

    Download
  • Data-Centric Security vs. Database-Level Security

    Database-level encryption had its origins in the 1990s and early 2000s in response to very basic risks which largely revolved around the theft of servers, backup tapes and other physical-layer assets. As noted in Verizon’s 2014, Data Breach Investigations Report (DBIR)1, threats today are far more advanced and dangerous.

    Download
  • Sponsored by One Identity

    One Nation Under Guard: Securing User Identities Across State and Local Government

    In 2016, the government can expect even more sophisticated threats on the horizon, making it all the more imperative that agencies enforce proper identity and access management (IAM) practices. In order to better measure the current state of IAM at the state and local level, Government Business Council (GBC) conducted an in-depth research study of state and local employees.

    Download
  • Sponsored by Aquilent

    The Next Federal Evolution of Cloud

    This GBC report explains the evolution of cloud computing in federal government, and provides an outlook for the future of the cloud in government IT.

    Download
  • Sponsored by LTC Partners, administrators of the Federal Long Term Care Insurance Program

    Approaching the Brink of Federal Retirement

    Approximately 10,000 baby boomers are reaching retirement age per day, and a growing number of federal employees are preparing themselves for the next chapter of their lives. Learn how to tackle the challenges that today's workforce faces in laying the groundwork for a smooth and secure retirement.

    Download
  • Sponsored by Hewlett Packard Enterprise

    Cyber Defense 101: Arming the Next Generation of Government Employees

    Read this issue brief to learn about the sector's most potent challenges in the new cyber landscape and how government organizations are building a robust, threat-aware infrastructure

    Download
  • Sponsored by Aquilent

    GBC Issue Brief: Cultivating Digital Services in the Federal Landscape

    Read this GBC issue brief to learn more about the current state of digital services in the government, and how key players are pushing enhancements towards a user-centric approach.

    Download

When you download a report, your information may be shared with the underwriters of that document.