This article originally appeared on hearland.org.
President Obama and the White House are swinging into campaign mode on his health care law today, with a Rose Garden event following multiple defensive Sunday appearances, announcements of changes to Obamacare???s homepage, and an admission that we???ve moved past the ???glitches??? talking point to one of ???unacceptable technical problems.??? In attendance at the Rose Garden will be some people who???ve successfully enrolled in Obamacare. Unlikely to be in attendance are any of the hundreds of thousands of people who???ve received recent notices that their coverage will be dropped ??? 460,000 in Florida and California alone.
Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.
The main reason insurers offer is that the policies fall short of what the Affordable Care Act requires starting Jan. 1. Most are ending policies sold after the law passed in March 2010. At least a few are canceling plans sold to people with pre-existing medical conditions.
By all accounts, the new policies will offer consumers better coverage, in some cases, for comparable cost ??? especially after the inclusion of federal subsidies for those who qualify. The law requires policies sold in the individual market to cover 10 ???essential??? benefits, such as prescription drugs, mental health treatment and maternity care. In addition, insurers cannot reject people with medical problems or charge them higher prices. The policies must also cap consumers??? annual expenses at levels lower than many plans sold before the new rules.
But the cancellation notices, which began arriving in August, have shocked many consumers in light of President Barack Obama???s promise that people could keep their plans if they liked them ???
Florida Blue, for example, is terminating about 300,000 policies, about 80 percent of its individual policies in the state. Kaiser Permanente in California has sent notices to 160,000 people ??? about half of its individual business in the state. Insurer Highmark in Pittsburgh is dropping about 20 percent of its individual market customers, while Independence Blue Cross, the major insurer in Philadelphia, is dropping about 45 percent.
The White House event is all optics, of course, which one Admin official frames compared directly to presidential pushbacks in the past: ???We???re kind of thinking of it as a tech ???surge,?????? even as HHS promises ???the best and brightest??? from the tech community will work on fixing the problems.
But how effective will this ???surge??? of the ???best and brightest??? be, given the critical structural and organizational problems? The whole of this big New York Times piece ??? where contractors express skepticism the system will even be workable in mid-December ??? is worth reading, but this part in particular is troubling:
One major problem slowing repairs, people close to the program say, is that the Centers for Medicare and Medicaid Services, the federal agency in charge of the exchange, is responsible for making sure that the separately designed databases and pieces of software from 55 contractors work together. It is not common for a federal agency to assume that role, and numerous people involved in the project said the agency did not have the expertise to do the job and did not fully understand what it entailed.
The people close to the project spoke on the condition of anonymity because they were not authorized to discuss the system???s problems. Administration officials have been debating whether to designate one or more companies as the quarterback for information technology work on the federal exchange, a complex project that has cost more than $400 million.
The struggles of Obama???s exchanges, though, aren???t an unmitigated good for those on the right, as Ross Douthat notes.
The wreck of the exchanges may actually be worse for conservative policy objectives than a more successful rollout would have been. That???s because while conservatives think the Obamacare exchanges are overregulated and oversubsidized, they are actually closer to the right-of-center vision for health care reform than the Obamacare Medicaid expansion, which is happening no matter what transpires with Healthcare.gov… Meanwhile, the task for serious conservative reformers ??? already not the most politically effective bunch ??? might actually become harder, because they would have to explain how their plan to build an effective, exchange-based marketplace differed from the Obama White House???s exchange fiasco.
Indeed, the one clear winner in this technocratic faceplant is the faction of the right that says nothing less than full repeal is acceptable, not the one ??? occupied by many center-right wonks ??? that has moved on toward attempts to make Obamacare more market-friendly. Given the political fractures active here, there is no incentive to move on toward a new bargain, and that???s unlikely to change for at least another presidential cycle.
Benjamin Domenech (firstname.lastname@example.org) is a senior fellow at The Heartland Institute.