Obamacare Shrugged

December 1st, 2013

The Affordable Care Act offered liberals a chance to prove that big government can work. Or, that big government and industry can work together to promote progressive goals. Or at the least, the government could offer a new entitlement program, that would not unduly disrupt the free market and allow people to maintain their personal choices. To date, the law has failed on all three fronts. Even if the web site is fixed (which the Administration says it has been), these first impressions will likely linger, and yield a skepticism for time to come on promises made by the government.

Here, I want to focus on the second item. The ACA was not single payer (much to the consternation of many liberals). Instead, it sough to work with insurance companies and private employers to make health insurance more affordable and available. I’ve written in the past how the insurance companies made the proverbial pact with the devil–supporting the President’s healthcare reform, and get an individual mandate that forces customers to buy their products. What could go wrong?

A recent profile of the HealthCare.gov rollout, and how the Administration turned on the insurance companies who did everything for them, is like a scene right out of Atlas Shrugged. Shortly after the “If you like your plan you can keep it promise” blew up, rather than accepting blame, the Administration first sought to blame the very insurance companies that forced the issue.

Mr. Bertolini and a dozen other insurance executives were quickly invited to a meeting at the White House. They arrived in the Roosevelt Room on Oct. 23 to find Ms. Sebelius, Mr. McDonough and Valerie Jarrett, the White House liaison to business, among others. The mood, participants said, was one of cooperation, not conflict.

“Everyone was trying to say, let’s roll up our sleeves,” said James Roosevelt Jr., a grandson of President Franklin D. Roosevelt and the chief executive of Tufts Health Plan.

But the good feelings evaporated as insurers started informing hundreds of thousands of existing customers that their plans no longer met basic, minimum standards required by the Affordable Care Act. With the website practically unusable, insurers were panicking; their customers could not log onto HealthCare.gov to buy new plans.

Customers “are not able to piece together the complete story right now,” one frustrated executive complained at the time.

Mr. Obama, meanwhile, was under assault. After years of telling Americans, “If you like your insurance plan, you can keep it,” he was being accused of lying. On the night of Oct. 28, Ms. Jarrett, one of Mr. Obama’s closest confidantes and a guardian of his personal credibility, took to Twitter to defend him — and to shift the blame.

“FACT,” she wrote. “Nothing in #Obamacare forces people out of their health plans. No change is required unless insurance companies change existing plans.”

The tweet touched a nerve; it was not the first time the Obama White House had used the insurance industry as a scapegoat. Ms. Ignagni’s members were furious. “Here it comes — we knew it would happen,” one executive recalled thinking.

Jarrett threw the insurance companies under the bus.

Then, to “fix” the problem, POTUS gave the insurers 6 weeks to change everything, and allowed them to reissue plans that had already been cancelled. This also shifted blame onto the insurance companies. “It’s not me. I would let you keep your plan. It’s Aetna’s fault!”

Inside the West Wing, where junior researchers monitor Twitter and other social media, officials knew the political controversy had moved beyond the broken website. Now it was about a broken promise. But for Mr. Obama, the mounting criticism was more than political. It felt personal.

“He was uncomfortable,” one senior adviser said. He hated the idea that so many Americans had received cancellation letters from their insurance companies and were angry because “of what the president had said — that this wouldn’t have happened.”

On Oct. 30, the president flew to Boston to talk about the Affordable Care Act at an event in Faneuil Hall, the Colonial-era meeting place where Mitt Romney, then the governor of Massachusetts, signed his own health care overhaul into law in 2006.

In addition to pledging again to fix the website, Mr. Obama for the first time acknowledged that not all people would be able to keep their health insurance. “For the vast majority of people who have health insurance that works, you can keep it,” he told the crowd. “So if you’re getting one of those letters,” he advised, “just shop around in the new marketplace.”


On Nov. 6, Ms. Landrieu and the other “2014ers” marched to the White House, where they spent two hours in the Roosevelt Room upbraiding the president and his advisers. Aides to Mr. Obama say the meeting was called, in part, to give Democrats a chance to publicly criticize the president — a message that Vice President Biden delivered to Representative Steny H. Hoyer of Maryland, the Democratic whip, in a separate meeting with several freshman Democrats.

“Just attack us,” Mr. Biden said, according to one person present. “Blame us.”

Anxious Democrats increased the pressure. Even former President Bill Clinton casually suggested in an interview on Nov. 12 that Mr. Obama should let people keep their insurance, even if it meant changing the law. And by the next Wednesday, with no change yet announced by Mr. Obama, Democratic lawmakers were in a full-blown panic.

In a closed-door meeting of the House Democratic Caucus, lawmakers excoriated David Simas and Mike Hash, two of Mr. Obama’s top health care strategists. “The administration hasn’t shown an ability to solve the problem,” one lawmaker told them. The two officials promised that the president’s team was working on a solution, and that it would come soon.

Despite lingering concerns inside the administration about the long-term impact on the health care law, the president announced his solution the next day: insurers would be allowed to renew old plans for a year. The announcement came just hours before a vote on a Republican bill to let insurers renew old policies and sell similar ones to new customers next year. Insurance executives, who had participated in lengthy conversations with Mr. Jennings and other officials, said they were unprepared for Mr. Obama’s about-face.

But the moved satisfied most Democrats. Only 39 voted with Republicans to alter the health law, far fewer than the White House had feared.

The fix threw the insurers even further under the bus. Compound this with the fact that the insurance companies stand to lose billions of dollars with the President’s “fix,” and are dependent on the administration broadly construing the so-called “risk-corridors” to pay them off, they are stuck.

This entire experience has been an abject failure for those who contend that government can competently accomplish these lofty goals.

Recently, the WSJ reprinted an exerpt Hayek’s Nobel Prize speech, the Pretense of Knowledge. There was no commentary, other than the lede, “Friedrich A. Hayek on the arrogant pretense of social planners.” There’s no mistake who they were referring to.