Former White House Health Adviser: Obamacare Will Work Just Fine...by 2016

WhiteHouse.govWhiteHouse.govFor a good idea of how anxious Obamacare supporters are about the law's rollout, read former White House health adviser Ezekiel Emanuel's op-ed in The Wall Street Journal this morning: 

Transforming the U.S. health-care system—which is larger than the economy of France—is one of the most daunting administrative tasks government has ever confronted. There will be bumps in the road; this is inevitable.

Setting up the exchanges will pose a host of technological challenges, such as digitally linking an individual's IRS information (which determines a subsidy level) to the insurance offerings in the individual's home area and to employment data—while simultaneously factoring in Medicaid eligibility.

Bugs in the computer software are bound to pop up, and the quality of the user experience will undoubtedly need improvement. Indeed, the Department of Health and Human Services has already improved the enrollment forms by reducing them to three pages from 21, and made them easier than the forms used by private insurers. But IT problems aren't the ones that should keep you up at night. Such glitches will be ironed out within a few years, and certainly by 2016 browsing your health-insurance exchange will be very much like browsing Amazon and other online shopping sites.

Got that? Obamacare's primary innovation—the health insurance exchanges—will probably work just fine...by 2016. This is not exactly confidence inspiring, and it suggests why some Democratic legislators are now openly worried about the law's implementation process. 

As with a lot of what we're finding out about the law now, it would have been nice if the administration and its supporters had admitted this a few years ago. But "Let's pass Obamacare even though half its coverage expansion probably won't have much effect on health and the exchange technology will be dysfunctional for the first couple years" probably wouldn't have been as convincing an argument. 

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  • steve sturm||

    Ah, what do you expect from someone with unabashed enthusiasm for big government programs? Actually, for someone like him to even acknowledge that there will be 'bumps in the road' is a big sign of just how screwed up things will be.

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  • Tman||

    Setting up the exchanges will pose a host of technological challenges, such as digitally linking an individual's IRS information (which determines a subsidy level) to the insurance offerings in the individual's home area and to employment data—while simultaneously factoring in Medicaid eligibility.

    Holy shit that just sounds terrible. Getting the IRS involved in your health care, I don't even.

    I realize that we've known about this before but seeing it written out like that is just appalling.

  • Aresen||

    Former White House Health Adviser: Obamacare Will Work Just Fine...by 2016

    I am sure that Team Blue is desperately hoping that it is working by 2016 because they are soooooo fucked if it isn't.

  • Adam330||

    There are elections in the fall of 2014.

  • Pro Libertate||

    Yeah, and I'm thinking bloodbath. Holy cow, are the wheels falling off.

  • Auric Demonocles||

    All they need to do is find one Republican anywhere in the country who says something stupid about women, rape, or birth control and they will be set.

  • Pro Libertate||

    There's a mystery line, somewhere further from sanity than I once thought, where I don't think we'll let the government take us. We like stuff too much.

  • Aresen||

    So far, Team Blue has been able to pass it off as being a "work in progress" and, with some success, blaming the GOP for the problems to date.

    (I am not saying the GOP is actually at fault, only that the administration and Team Blue supporters have been able peddle that BS with some success. Unfortunately, a majority of the US electorate wants their "Free" healthcare and, since the Dems have promised it, the fact that the peepul can't have it is SOMEBODY'S FAULT.)

  • Auric Demonocles||

    This is the most insane part. It's like a couple of people were living together and one decided to get a dog, and the other guy said "We shouldn't have a dog. I am not going along with getting a dog, and I refuse to help with it." Then person A gets the dog anyway, and when it gets an expensive vet visit or poops all over the floor they blame person B for not doing their part to take care of Fido.

  • Aresen||

    Person B could always call the cops.

    :}

  • John||

    No. They haven't passed off anything. What has happened is most people don't pay a lot of attention and haven't noticed the effects yet. All the spinning and lying is just noise to most people. The full effects will kick in gradually throughout the year.

  • Aresen||

    I don't think the problems will bite hard enough in time to cost Team Blue in the 2014 elections. Team Blue has been able to blame GOP obstructionism and I think they will be able to play that with some success until after Nov 4/14.

    Traditionally, the party holding the WH takes a hit in the non-presidential year elections, but I don't think Obamacare will factor much in that.

  • DRM||

    They could have been made to pay attention . . . except Team Red ran one of the only two Republicans on Earth who couldn't run against Obamacare. (The other being Joseph Cao, who voted for the thing in the House.)

  • Jayce||

    We've had nearly 100 years of absolute failure of progressive policies, and most people haven't noticed a damned thing.

    This won't be any different.

    After this flames and burns, the Administration, Congress, Paul "cranio-rectal" Krugman, and the rest of the Progressive Posse(tm) will swear that any problems were because it didn't go far enough. It'll be the stimulus excuse times ten. Then we'll get nationalized health care.

  • DRM||

    You think so?

    Team Red, not having an incumbent it has to stick to, will run Chris Christie in 2016 as part of their "Okay, we need a 'moderate'" strategy, as previously seen in 1996, 2000, 2008, and 2012, and as defended in these comment threads by Tulpa.

    And it will lose, just like it lost each of those times (with an asterisk on 2000, when it lost the popular vote but Bush squeaked in anyway).

  • Mr. Soul||

    Paging Dr. Howard, Dr. Fine, Dr. Howard.

  • ||

    Which is the scariest sentence?

    1. Italian Premier Enrico Letta sees Spain as a partner in the battle to reduce Europe's focus on budget austerity.
    2. North Korea has told foreign embassies in Pyongyang it cannot guarantee their safety in the event of conflict, and to consider evacuating their employees.
    3. Transforming the U.S. health-care system—which is larger than the economy of France—is one of the most daunting administrative tasks government has ever confronted.
  • ||

    3.

  • ||

    Yep. "Transforming" a literally life-saving seventh of the US economy is an "administrative task".

    This guy is right out of the Politburo.

  • sasob||

    But "Let's pass Obamacare even though half its coverage expansion probably won't have much effect on health and the exchange technology will be dysfunctional for the first couple years" probably wouldn't have been as convincing an argument.

    Just a hunch, but I think the bill's supporters didn't need much "convincing" - they'd have voted for it anyway.

  • Auric Demonocles||

    They needed convincing. It's just that the convincing only had to be as thorough as "Europe has government healthcare!"

  • Greg F||

    ...and the exchange technology will be dysfunctional for the first couple years

    Yea ... by then they will have changed the definition of 'dysfunctional'.

  • John||

    Forgetting for a moment what a horrible tragedy this is going to be for so many people, how pathetic and funny is this guy? You see there is this magic software that is going to make everything better. Sure things are not looking good now. But that is just because there are the usual bugs in the magic software.

    That has to be the post sad and pathetic thing I have ever read in my life.

  • Invisible Finger||

    The true believers mantra "It isn't working because we're not spending enough money on it" sure has started early.

  • Libertarian||

    Ugh. As odious as it was, I don't hear the term "repeal and replace" used anymore. Wish I was a better searcher of the H and R archives: seems to me that within a month of passage, Nick or someone else posted that a couple Repugnantcans were saying it was too late for repeal. In short, and in reality, I doubt by 2016 that whatever the state of disarray, Obamacare will be here to stay. Some exchanges will exist. Some people will be using the system. Yada, yada, yada.

  • Health Care||

    I think..All they need to do is find one Republican anywhere in the country who says something stupid about women, rape, or birth control and they will be set.

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