One cannot help but be struck by the monstrous incongruities between the hopes Obamacare engendered and the grubby realities of its passage, implementation, and results. The ACA was sold with messianic visions and utopianism. Nancy Pelosi promised Obamacare would free us from work – we could all quit our jobs and take up the violin. But these were just tactics, deliberate strategies to neuter opposition to the bill. In this series, the Truth Squad exposes the methods used to pass Obamacare (the lies, the deceit, the orgy of lobbying). We also hold Obamacare’s proponents accountable for the results (e.g., the botched roll-out). It was not the “stupidity of the American voter” that allowed Obamacare to pass. We had a huge game run on us by masters of deceit who should never be trusted with public policy again.
The page references are from the 2015 book America’s Bitter Pill by Steven Brill.
Part 1 – Special Interests
Part 2 – Deceit
Part 3 – Botched Rollout
Part 4 – Other Perversities
Botched Roll-Out by the Keystone Cops of Healthcare
- There was total confusion about who was in charge of Healthcare.gov. Nobody was. Seven different people were thought to be in charge, and there were four or five different ‘command centers’. (p. 289)
- In an interview with the author, President Obama admitted there should have been a single person, a Marketplace CEO, in charge. He went on to make more empty promises about how he will improve digital services across the government in the future (p. 470). (A CEO was appointed for Healthcare.gov’s second year, proving the complete negligence that took place the first year
- The problem of income verification and ensuring correct subsidy amounts was flagged before the law was passed. (p. 181) In April 2010, the head of the IRS said the verification process would be a “nightmare”. (p. 202) The employer and insurer reporting requirements (name, SSN, hours worked, insurance coverage, etc.) were so complicated that they were pushed back a year. (pp. 290-291) (This mess still isn’t straightened out; a stunningly high percentage of affected taxpayers had to repay part of their subsidies after the first year because of the convoluted way the subsidies were calculated.)
- There still had been no independent software testing and no consumer testing of the website three months before the launch (p. 292) (More on the consequences of the failure to test – p. 334)
- There was serious understaffing on the build team. (p. 293)
- Upon receiving a memo outlining a host of problems with the website construction effort, a senior official worried only about his own future. He asked for help refuting the memo, not solving the problems it highlighted (p. 293)
- The main contractor CGI absolved itself from responsibility for delays, citing budget constraints and changing specifications. (p. 294)
- A consultant’s report identified numerous ‘high risks’, ‘defects’, and technical shortcomings before launch, but the report was not shared among project leaders. (p. 296)
- Plans for educating the public remained vague. The government was very late in getting out RFPs for navigators. (pp. 276-77) HHS Secretary Sebelius resorted to soliciting private donations to shore up Enroll America. (p. 278)
- The official White House “Enrollment Countdown” (project completion calendar), played up in the press as detailing what needed to be done every day in the weeks before launch, was BLANK. (p. 300)
- President Obama held regular meetings about the Healthcare.gov rollout with staff but the meetings were political in nature, all about how to boost enrollment. “No one in the room had any idea how or if the technology worked.” (p.301) The President stammered later about creating a culture where staff is not afraid to admit there is a problem, but he obviously failed at building such a culture just as badly as he failed at building a website.
- HHS Secretary Sebelius was offering assurances that everything was on track in the days before the calamitous rollout. (p. 308)
- T-minus one day: White House Chief of Staff McDonough, “We’re gonna knock your socks off tomorrow.” (p. 322) #clueless
- Building Healthcare.gov cost $840 million as of March 2014, triple the original budget. (p. 405) Despite the stratospheric cost, Sen. Max Baucus famously warned the rollout would be a “train wreck”.
- And a train wreck it was. After the rollout, people were getting canceled, making them liable for the ACA individual mandate fine even though they couldn’t buy new policies because the website was broken. “This is what happens when you inject 159 new federal agencies, bureaucracies, and commissions between you and your healthcare.” -Rep. Kevin Brady (R-TX) (p. 368)
- In an interview with the author, President Obama admitted he failed in launching Healthcare.gov. (p. 464) This was his most important domestic policy initiative, but he couldn’t be bothered to do it right. (p. 314)