How to Fix the Health-Exchange Fiasco
In Oct. 21 remarks in the White House Rose Garden, President Barack Obama said healthcare.gov, the website that is supposed to be the conduit through which people buy insurance under the new health-care law, “hasn’t worked as smoothly as it was supposed to.” That’s a little like saying a plane that crashed into a mountain, caught fire, and exploded didn’t land as smoothly as it was supposed to.
Obama didn’t say what went wrong, why, or who was to blame. He offered no details about what the administration is doing to fix it (“We’ve got people working overtime”), or how long it will take. And he expressed no contrition, saying only that “Nobody’s madder than me.”
The healthcare.gov implosion doesn’t say much about the soundness of Obamacare writ large or the philosophical complaints that continue to plague it. The Affordable Care Act is more than a website; it’s a commitment to provide insurance for people who can’t get it.
What the past three weeks have changed, abruptly, is the public’s confidence in the administration. Healthcare.gov is the face of Obama’s signature domestic achievement, rolling out according to a schedule that’s been fixed in law for three and a half years. When the administration blows this kind of big project, it only corroborates Republicans’ feverish arguments that government cannot do anything efficiently.
To regain public trust, here’s what the administration has to do:
First, obviously, it has to fix the website. The administration must decide whether to strip responsibility for managing the project from the Centers for Medicare and Medicaid Services and give it to one or more contractors with the capacity to run such a project. Insurers, which depend on healthcare.gov for the information they need to process applications, say the government has told them neither how nor when it will fix the site.
Second, the administration should make clear whether, and under what circumstances, it might delay the tax penalty for people who are unable to buy insurance through the exchanges. That would impose some meaningful deadlines on the race to fix healthcare.gov.
Third, the president should demonstrate that failure has consequences. Obama is fond of comparing the rollout of healthcare.gov to that of an Apple product. Surely, if barely 1 percent of the people who tried to use the company’s latest operating system could do so, the executives responsible would not keep their jobs.
Until the website problems are resolved, nobody cares how mad the president gets. All that matters is whether he can do the job.