The Affordable Care Act Hits Real Turbulence

By on October 29, 2013

TBJust when it seemed that the Obama Administration had slain the dragon of Conservative opposition and emerged ready to move ahead to implementation, the real threats to the Affordable Care Act blew into town. Unlike the huffing and puffing of politicians like Ted Cruz and John Boehner, this latest ill wind could indeed damage the reform movement and set it back years.

The first gusts came during the roll out of the HHS national website. Everyone from Saturday Night Live to the Tea Party has gleefully made fun of the technical problems encoutered by Americans going on to the site shopping for affordable health care. No matter that Republican state legislatures and governors have been eagerly throwing their wooden shoes into every aspect of the roll out, the Administration should have appreciated how crucial this large scale undertaking would be to its over all success and planned accordingly. These early glitches alone would have been easily patched and forgotten if other probelms had not surfaced soon afterwards.

This week it appears that many adults with sub-standard individual plans, those with catastrophic insurance, plans with high co-pays, high deductibles and carve-outs, the kind that often lead to individual bankruptcy, are seeing their policies cancelled and more expensive plans offered in their places. Worse, insurance companies have once again passed on very high price increases to their customers, as they did in 2010 when the law was passed and in 2003 when Medicare Part D was enacted. This is the price of insurance industry cooperation in the passage of the 2010 Act. They got much of what they wanted, including many more customers. Now they want high profits for their shareholders. If there is great waste in the American system, it is in the redundancies of countless insurance companies each with its stockholders and massive overhead adding cost if not value to the system.

The latest blast of cold air comes from an NBC report that the Administration knew this would happen and persisted in the message that “if you like your insurance policy, you can keep it” anyway. Obama should have learned from his predecessors, Bill Clinton on having sex with Monica Lewinsky and George Bush on weapons of mass destruction as a reason to go to war, that misleading the American people with lies and misinformation takes a toll on your authority in Washington. This reform needed a massive communication strategy to put it across from the start. The changes are complex. The toes that will be stepped on are many. These toes are connected in many cases to bodies that will have large amounts of cash ready to use in retaliation. Campaigns of mis-information have successfully spooked the country since the Alien and Sedition Acts of 1800.

Increases in insurance premiums were coming whether there was reform or not. Difficulties along the way were bound to surface given the magnitude of the change. If the president loses the support of younger middle class voters in this process, he will spent the rest of his term just trying to move reform ahead at all. I know he would like to address immigration reform, climate change and artillery control as well, but he would be well-advised to push these to the back burner for now, and concentrate on getting health care reform right while there still is time.  The stability of our economy depends on successful implementation. It’s too late to go back to the drawing board in the current political climate. Determined leadership and straight communication must follow in the months ahead.


Tom Godfrey

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