October 11 2013
Is ObamaCare a Potemkin Village?
QUOTE OF THE DAY:
The Obama administration has an implementation problem. More than any administration of the modern era they know how to talk but have trouble doing. They give speeches about ObamaCare but when it's unveiled what the public sees is a Potemkin village designed by the noted architect Rube Goldberg. They speak ringingly about the case for action in Syria but can't build support in the U.S. foreign-policy community, in Congress, among the public. Recovery summer is always next summer.
They have trouble implementing. Which, of course, is the most boring but crucial part of governing. It's not enough to talk, you must perform.
There is an odd sense with members of this administration that they think words are actions. Maybe that's why they tweet so much. Maybe they imagine Bashar Assad seeing their tweets and musing: ""Ah, Samantha is upset—then I shall change my entire policy, in respect for her emotions!"
--Peggy Noonan in today’s Wall Street Journal (sorry, subscription required)
The administration's implementation problem may be worse than we know.
Michael Astrue, a former general counsel to the Department of Health and Human Services, exposes a peculiar aspect of implementation problem: It seems that HHS already knew a year ago that it would not be able to launch the network of exchanges in even a “minimally acceptable” way—yet nobody in the administration deviated from the talking points, which assured the public that the computer system would be ready by Oct. 1.
As the launch date drew near, Astrue notes, the administration did switch gears somewhat and began to talk about “glitches” in the system. But a glitch is something small. The article suggests that the meltdowns in the computer system—which cost the taxpayer in excess of half billion dollars—are not glitches at all but reflect fundamental errors in an unworkable system. One of the biggest blunders:
HHS blundered when it allowed states to rely on self-attestation to verify eligibility for public subsidies in states that built their own exchanges. Experience with the Earned Income Tax Credit and other programs strongly suggests that in states that rely on self-attestation a high percentage of those who receive subsidies—probably 20-25 percent—will be ineligible. HHS has refused to explain how it will recoup payments from ineligible recipients. The official responsible for preventing this waste, fraud, and abuse, the HHS inspector general, has been silent about this problem as well.
That’s just the beginning. It seems that the computer system was also designed in a way that violates the Privacy Act. This means that if someone enrolls in a health plan through an online exchange, a family member (including a recent ex-spouse) can go into the system and change it without written permission. That doesn’t sound like a mere glitch. Nor does the hiring of an army of “navigators,” who have not been screened but who will have access to applicants’ most private information. This opens a door to massive fraud. So does the incompetence that caused the Minnesota exchange to disclose the Social Security numbers of 2,400 citizens, even before the exchange opened for business.
You will be told many times in the coming months that continuing computer issues are mere “glitches.” Instead, failures of the exchanges will be common and serious. These failures will wreck the lives of many Americans when their identities are stolen by hackers or navigators, or their Social Security numbers are inadvertently disclosed by an unaccountable Affordable Care Act bureaucracy. When you hear assurances about “glitches,” remember that their purpose is to mislead.
The failure of the system is all the more puzzling when one recalls the dazzling performance of the Obama campaign’s election day technology, especially compared to the Romney team's pathetic Orca. The program was tested before election day and worked perfectly, contributing to the president's numbers. Commentary’s Bethany Mandel suggests that, if President Obama cared as much about governing as he did about being re-elected, the ObamaCare system might not have been such a mess.
Maybe this administration can talk but can’t implement, as Noonan wrote. Noonan argues that the rollout is so bad that it’s not time to give up on the idea of delaying ObamaCare. Key members of the House GOP continue to believe that delay is crucial because, they fear, once implemented, ObamaCare is here to stay. An alternative theory might be that we should go full steam ahead. The sooner we do this thing, the sooner it will be over. If the first two weeks are any indication, ObamaCare is going to be its own worst enemy.