Liberally yours is a regular column at the Daily Caller featuring Thom Hartmann, the number one progressive radio host in the country, in conversation with libertarians and conservatives. This week, he’s joined by Alex Smith, chairman of the College Republicans, to debate the Obamacare rollout.
Thom:
Obamacare is working fine. Yes – you heard me right: Obamacare is working fine. Well, at least in the states that aren’t run by the Tea Party. Now that the shutdown is over, the media has moved onto its next manufactured controversy: the glitchy roll out of the Obamacare health exchanges. Right after the exchanges opened on October 1 – newspapers and TV networks started reporting that some users were having problems with Healthcare.gov.
Stories about Healthcare.gov fell into the background during the 24/7 coverage of the shutdown – but since the president signed a bill to reopen the government last Thursday– cable news cycles have been running non-stop features on the site’s problems. And let’s be honest – these problems are pretty bad. Healthcare.gov crashes, runs slowlyand sometimes gives users bad information about the tax credits that make health insurance under Obamacare so much more affordable.
Predictably, Fox News has jumped on these problems to make it seem like Obamacare as a whole is doomed. HealthCare.gov’s problems are embarrassing and the Obama administration needs to fix them if it wants its healthcare law to work. But here’s the thing: lost in all the very justified talk about how screwy the site is, is any talk about why the website so screwy and who made it that way.
Remember, the Healthcare.gov exchange site was meant to be a portal. It was never designed to bring together a bunch of different insurance policies and put them in one place. Instead, when the government first set-up the federal exchange system, it thought that states would, you know, cooperate with Obamacare and set-up their own exchanges.
The Healthcare.gov portal would verify people’s citizenship and eligibility, and then hand them off to the website of the state they live in. The state website would then have its own unique database reflecting different state standards for income eligibility, Medicaid eligibility, and the different health insurance companies that chose to participate in each state. Thus, the states would bear most of the burden for building the exchanges.
But Republican-run states didn’t co-operate. Tea Party Republicans convinced 36 states to not set-up their own exchanges. Because so many of these Republican governors said no to helping out their own states — the federal government had to step in and do their job for them on the Healthcare.gov website.
This meant plugging in a boatload of information about each of these 36 states’ insurance rules onto one site – Healthcare.gov – on very short notice. This is a pretty complicated task – and any problems the site is having right now are really the fault of the Republican state lawmakers who decided sabotaging Obamacare was more important than helping their people get healthcare. So when Fox and Republicans talk about how the site is not working, they’re not complaining – they’re bragging.
Ironically, Obamacare is working pretty well in the states that set-up their own exchanges. The state exchange sites have had some problems — every website does when it first comes out – but as Jonathan Cohn pointed out in the New Republic, “Consumers are getting opportunities they never had before – to shop for insurances, each one with clearly defined benefits … 180,000 have completed applications for insurance [in the state exchanges] and, of those, 50,000 have enrolled.”
Of course – you’re not going to hear that on Fox News. During a speech at the White House earlier today – President Obama announced that his administration is working hard to fix Healthcare.gov’s problems. Let’s hope the president and his administration can get the Republican-caused Obamacare rollout mess sorted out quickly. And let’s also hope that they call out the Tea Partiers who screwed it up to begin with.
Alex:
In the wake of the failed Affordable Care Act rollout and a flurry of cancellation notices from insurance carriers, defenders of one-size-fits-all government have been sent scrambling to defend this disastrous piece of legislation. The latest line of attack is particularly amusing: that Republican governors are to blame for choosing not to set up state-run exchanges.
The Affordable Care Act required the government to set up online marketplaces known as exchanges, where individuals can purchase plans and apply for government subsidies to help pay for them. The law allowed states to create their own exchanges, but only fourteen states opted to do so. The other 36, largely run by Republican governors, refused to create their own exchanges, pushing these states into the federal marketplace.
Amid the struggle to find any positive news in the lackluster premiere of the President’s signature piece of legislation, proponents have clung to the success of the state exchanges. Of course, relative to the completely unworkable federal website, success by these terms is defined as simply functioning.
Has the rush to control this PR nightmare for the administration led supporters to make misguided states’ rights arguments? After all, a recent report from the Seattle Times on the glitch-free Washington State exchange website attributed its success to “proximity to those with a stake in the system: insurers, state eligibility departments and consumers,” reads like a textbook argument for federalism. Even more pathetic was the president’s visit to Massachusetts designed to draw a specious parallel between his leviathan health care plan and the bipartisan state plan enacted under then-Governor Romney.
To be clear, these early plaudits relate only to the functioning of the website, and common sense should dictate that local contractors creating one website for one state will have more success than a single contractor working to integrate thirty-six different states into one interface. But Republican governors were right to look past merely building an operational website.
The taxpayer bill for these state websites has already come in at over one billion dollars. Driven out by costs, big insurance companies are slowly pulling out of the state exchanges, ultimately hurting consumers, who will undoubtedly see prices rise with a lack of competition. Moreover, the majority of enrollees on the state websites are those signing up for Medicaid at no cost to them, rather than consumers buying private insurance, who are needed to keep the system afloat. The legislation was so hastily written and passed by congressional Democrats that it failed to specify that the tax subsidies applied in states that used the federal exchange, prompting a series of lawsuits that may, in fact, render the law inapplicable in these states.
In short, the ACA provision allowing for state-run exchanges was a false choice meant to offer a state the chance to regulate its own insurance market, but to disclose little about the actual role the federal government would play and the costs of implementation. As early as November 2012, Governors Kasich, Walker, Scott and Christie all voiced concerns over these matters in rejecting the exchanges. The Republican governors, who called the administration on its bluff, seem to have now been vindicated by the law’s early stumbles.
Of course, there are no winners in the President’s health care takeover. The residents of the 36 states without state exchanges have been punted into a federal system that is unusable and will face fines for failing to enroll by the March 2014 deadline. The Republican governors, however, showed leadership in not opting into a vague and unwieldy provision of the law that would have cost their states millions and taken away their ability to serve the citizens they swore to protect. Republican Attorneys General deserve credit, too, for remaining vigilant in bringing ACA-related lawsuits against the administration on Tenth Amendment grounds. These leaders have done right by their constituents, and to blame them for the colossal failures of the most partisan and intrusive piece of legislation ever signed into law is a poorly disguised attempt to avoid the responsibility that is owed to the american people.
Here’s a promise you can count on: if you like your freedom, you can keep your Republican governor.