Obamacare Problems Continue

Those hoping for the Obamacare websites to be more functional are bound to be disappointed by this piece. And this one. Ross Douthat finds himself more than a little surprised by the way in which the Obamacare rollout has flopped:

THIS is not the column about the Obamacare rollout I expected to write.

If you had told me, months ago, that weeks after the health care law’s coverage expansion went into effect I would be writing about the problems its launch had exposed, I would have assumed I’d be writing about rate shock, rising premiums and the disappearance of many cheap insurance plans — basically, all the problems conservatives have worried will make Obamacare a ruinously expensive failure if they play out as we fear they might.

I may be writing about those issues soon enough. But for now there is a more pressing subject: The online federal health care exchange, the heart of the Obamacare project, is such a rolling catastrophe that it may end up creating a major policy fiasco immediately rather than eventually.

This fiasco has always been a possibility, for reasons inherent in the architecture of the law. When The New Republic’s Jonathan Cohn, the most rigorous defender of the entire reform project, wrote up his “five Obamacare anxieties” in May, the first one was structural: The system’s sustainability depends on getting enough healthy people to sign up, he pointed out, and if they don’t then insurers “will have to raise everyone’s premiums,” which “could create what actuaries call a ‘death spiral’: Rising premiums prompt people to drop out, causing premiums to increase even more.”

Cohn thought such a death spiral was unlikely, and frankly so did I. Between the stick of the mandate, the carrot of subsidies and the planned P.R. blitz, it seemed as if enough Americans would sign up to at least postpone the cost problem and get the system off the ground.

But it seemed that way because it was hard to imagine the Obama White House botching the design and execution of its national health care exchange. Building Web sites, mastering the Internet — this is what Team Obama does!

Except this time Team Obama didn’t. Like the Bush administration in Iraq, the White House seems to have invaded the health insurance marketplace with woefully inadequate postinvasion planning, and let the occupation turn into a disaster of hack work and incompetence. Right now, the problems with the exchange Web site appear to be systemic — a mess on the front end, where people are supposed to shop for plans, and also a thicket at the back end, where insurers are supposed to process applications.

You know that the president is in trouble when a Team Obama enterprise ends up getting compared to the war in Iraq. Even Consumer Reports has decided to comment on this giant SNAFU, telling people that they should stay away from the Obamacare websites “for at least another month” until things are (perhaps) fixed. Meanwhile, the administration–which didn’t want to bring in outside companies for fear that they may get subpoenaed by Republicans–has now been forced to bring in an outside company in order to clean up the mess. One wonders why they didn’t just do this from the beginning.

Michael Scherer is urging the president to “get mad” about the broken websites, and the president has obliged. Would that Scherer would have called on the president to get competent instead. I don’t doubt that there is room in this debate for more than a little righteous anger, and writing for myself, I would like to see a healthy dose of that anger directed towards Kathleen Sebelius when she testifies to Congress. Speaking of Secretary Sebelius, perhaps she could be transferred to a different government job.