Reason’s 12 “Broken Promises” of Obamacare

January 19th, 2014

In the January edition of Reason, Peter Suderman lists the top 12 “broken promises” of Obamacare:

1. “If you like your insurance plan, you will keep it.”

Reality: According to a November 4, 2013, report in Politico, more than 3.5 million Americans have been hit with health plan cancellations. Millions more are expected to follow.

2. “What we said was you can keep it if it hasn’t changed since the law passed.”

Reality: President Obama promised repeatedly, with no caveats or qualifications, that people who liked their plans could keep them, and that no one would ever take them away, period. Versions of the promise were captured on video at least 36 times.

3. “If you like your doctor, you will be able to keep your doctor, period.”

Reality: People who can’t keep their plans often can’t keep their doctors, because doctors are affiliated with particular networks and insurers. Many of the new plans offered through the law’s insurance exchanges were built with narrow networks to keep costs down. Top hospitals are available under relatively few of the exchange plans, generally those with relatively high premiums.

4. “We’ll start by reducing premiums by as much as $2,500 per family.”

Reality: The average annual premium for an employer-provided health plan rose from $13,375 to $16,351 between 2009 and 2013, according to a survey by the Kaiser Family Foundation. Prices for individual market plans like those found on the exchanges are also up, with the average state facing premium increases of 41 percent, according to a November 2013 analysis by Manhattan Institute health policy analyst Avik Roy.

5. “It will create 4 million jobs-400,000 jobs almost immediately.”

Reality: The gush of jobs never materialized. The unemployment rate slowly receded in the months after Obamacare passed, but largely because more people had quit searching for work. By 2021, according to projections by the Congressional Budget Office, the law is expected to shrink the nation’s work force by about 0.5 percent, since fewer people will hold onto their jobs to maintain their health insurance.

6. Obamacare “pushed back on the undue influence of special interests.”

Reality: Obama cut deals with major incumbents in the health care industry to obtain their nearly unanimous support. America’s Health Insurance Plans, an industry group, backed the law because of the individual mandate to buy health insurance. The American Medical Association was reportedly promised that, in return for its support, Democrats would fix the way Medicare pays doctors-a fix that never came. And as documents released by congressional Republicans eventually revealed, the White House cut an explicit deal with the pharmaceutical industry guaranteeing that the administration would not pursue several policies that drug makers opposed, in order to get the industry’s support for the law. Meanwhile, Obamacare has never been popular with the public it was supposed to be working for.

7. “We are on schedule, and will be ready for the marketplaces to open on October 1.”

Reality: The launch was a disaster, with serious problems in many state exchanges and with the federal website freezing up just minutes after going live. It was a catastrophe that some in the administration knew was on the way. “Confidential progress reports from the Health and Human Services Department show that senior officials repeatedly expressed doubts that the computer systems for the federal exchange would be ready on time,” The New York Times reported on October 12, 2013.

8. “Regardless of how the Marketplace is managed, consumers will be able to access the Marketplace with ease.”

Reality: As Obama and Cohen were making their promises, they had no idea whether the site would even be functional. On September 26, the day of Obama’s Maryland speech, “there had been no tests to determine whether a consumer could complete the process from beginning to end,” according to an October report in The Washington Post. That month Businessweek reported that such testing still had not been conducted.

9. “We expect to resolve these issues in the coming hours.”

 Reality: The problems went much deeper than the administration initially claimed. Six weeks after launch, online enrollment in the federal exchanges was still stymied by serious technical failures. “The website is not working well,” White House Press Secretary Jay Carney admitted on November 7, and it “hasn’t been working well for the first month of the rollout.” An HHS report later revealed that the site had been accessible just 42 percent of the time during the month of October.

10. “Take away the volume, and it works.”

Reality: Volume dropped, but malfunctions continued. Outside experts contacted by multiple news organizations found many shortcuts, messy construction, and unnecessary functions in the visible portions of the code. And insurers reported that the enrollment information they were receiving from the system was frequently flawed. The system was not just overwhelmed; it was poorly designed.

11. “No, we don’t have that data.”

Reality: Leaked notes from the administration’s daily Obamacare war room meetings later revealed that on launch day there were a total of six enrollments through five different insurance issuers. By the second day, the number had climbed to 248. The numbers were terrible, so the administration pretended they did not exist.

12. “[We] follow high standards regarding the privacy and security of personal information.”

 Reality: By launch day, the deadline-driven operational demands outweighed security concerns. The exchange went live under a last-minute temporary security authorization signed by Marilyn Tavenner, the head of the Centers for Medicare & Medicaid Services. It said “aspects of the system that were not tested due to the ongoing development exposed a level of uncertainty that can be deemed as a high risk.”