ACA RollOut Saga Continues

The rollout of Obamacare’s exchanges is widely, and rightly, being panned as the kind of fiasco that gives government-run anything a bad name. If the administration does not fix the on-line registration website, and fix it soon, they will have thrown their baby to the wolves, which is not a mark of good parentage. Not only does the failure to ensure a smooth rollout feed the narrative of the law’s opponents, it feeds the overall anti-government meme that is the rallying cry for the Tea Party.

Once again, Secretary of Health and Human Services Kathleen Sebelius has proven herself unequal to her task. I watched her interview the other night with Sanjay Gupta. It was pathetic. Gupta is not Sean Hannity, yet even he was clearly struck by Sebelius’ weak, unthoughtful responses. When she promised to “bring the A-Team” to fix the problems with the website, Gupta correctly asked why she had not brought the A-Team in the first place, especially seeing as HHS had spent some $300 million on this rollout? Sebelius could not entice a five year old to a bowl of Count Chocula breakfast cereal.

The President was not much better. I know that the task of rolling out a health care website is different from planning a mini-campaign rally, but if the White House staffers are planning an event designed to pledge a more competent approach, who decided to put a pregnant woman with diabetes standing in full sun immediately over the President’s right shoulder? In his speech it was hard to tell whom he was more peeved at, the Republican obstructionists or his own appointees.

In this morning’s Washington Post, E.J. Dionne points out that the problems with the rollout cut both ways. The Affordable Care Act included peculiarities that were designed to take account of Republican sensibilities. The law includes a hefty dose of federalism, permitting the states to set up their own exchanges and further encouraging the states to expand Medicaid, the joint federal-state program that provides health care to the poor. Those states that followed the law’s model, expanded Medicaid and set up their own exchanges, are not encountering many of the problems associated with HealthCare.gov. From California to Connecticut, the state exchanges are working and working well. In Oregon, the state exchange website also had some glitches, but in the first weeks, the rate of uninsured dropped by ten percent, largely through the Medicaid expansion.

Those states that balked at expanding Medicaid, and refused to create their own exchange, certainly complicated the federal exchange. Each state has different insurance regulations that must be considered. This opposition is foolish – why would any governor not want to see more of the residents of her state get insurance? – but it was also foreseeable. It does not amount to a pass for Sebelius.

That said, the hypocrisy of the Republicans is astounding. For two weeks, they shut down the government with the goal of defunding or delaying Obamacare. The GOP-controlled House has voted to repeal the ACA fifty times. The refusal to expand Medicaid or to set up a state exchange is unique to red states. They have precisely no moral standing to now complain that people are having a hard time signing up for health insurance when those same Republicans have fought long and hard to keep those same people from even having the opportunity to sign up for health insurance, no matter how long they have to sit at a computer navigating Healthcare.gov.

Last night, on “All In with Chris Hayes,” Ohio State Rep. Matt Lynch tied himself in knots explaining why he and five other Republican legislators are suing the state’s Republican Governor to frustrate the attempt to expand Medicaid. Kudos to Gov. John Kasich for his commitment to expanding Medicaid which will result in some quarter of a million people acquiring health insurance. But, what was really appalling was Lynch’s comments about the effects of not expanding Medicaid. “I drove from Columbus to Cleveland today and I did not see anyone terrorized by the lack of health insurance,” he said. Perhaps he was driving too fast. I do not live along the road from Columbus to Cleveland, but I am happy to explain to Rep. Lynch just how scary it is to lack health insurance.

And where, O where is our Church in all this? Many have commented on the fact that the agenda for the USCCB meeting next week is a little thin, that it does not reflect some of the pastoral priorities Pope Francis has set before the leaders of the Church. I have a suggestion: Let the bishops discuss how they can use the Church’s various social service agencies and its many parishes and schools, to help the poor sign up for health insurance. It is true that our Lord Jesus Christ did not pronounce any judgment on the Affordable Care Act, but He most certainly left us the example of healing the blind and the lame, caring for the poor, indeed becoming poor, and establishing the absolute dignity of the human person as the foundation for all we believe about human ethics. The lack of adequate health care insults that dignity. Helping poor and working poor folk get health insurance they have previously lived without is a good thing to do. The bishops should encourage every institution and organization that bears the name “Catholic” to help get people enrolled.

As for the supporters and opponents of Obamacare here in Washington, there is no hope that they will ever convince each other. Even if the rollout had been smooth as a baby’s cheeks, the critics would not have been silent. But, the stakes are high, very high, for the Democrats. If they cannot fix the problems with the rollout of the ACA, they will have damaged the possibility of progressive government policy for a generation and put at risk the signature achievement of this administration. They need more than a pep talk from the Rose Garden. They need results and they need them fast.