Oct. 28 (Bloomberg) -- Dear [Senior Administration Official]:
First off, I’m happy to keep working on retainer to provide advice for you guys. But let’s be clear: Whoever is processing my payments had better not be using the same IT guys as Obamacare, OK?
All right. Nobody warned me what a disaster the Affordable Care Act websites would be. We war-gamed everything that could go wrong, from higher premiums to employers dropping coverage -- everything except this. So now is when I start to earn my keep.
Let me start by telling you what not to do: Don’t minimize the problem. Don’t say that a lot of private companies have trouble when they’re getting started, or that the websites are only a part of Obamacare. Everybody understands that the websites are crucial to the exchanges and that the exchanges are crucial to the law. That’s why we didn’t just call it the Transfer-Money-From-Medicare-to-Medicaid Act.
And don’t blame Republicans. Could one of you call Howard Dean and tell him that his line -- that Republican governors who didn’t set up their own exchanges are actually at fault -- is a surefire loser with everyone who isn’t already on team blue? We can’t be out there arguing that our plan was just perfect except it depended on everybody suddenly deciding to take optional steps to help a law they hate. Besides, a lot of the state exchanges aren’t working well, either. For an additional fee, my colleagues will be happy to explain these points to any Democratic official or ex-official who needs it.
Oh, and blaming the contractors and saying “heads should roll” doesn’t seem all that smart, either. What’s the plan here? We’re going to get a whole new technology team up to speed as the clock is ticking? We’re going to ask the old team that we’ve been trashing in the press to help get them up to speed? No. The old team is going to have to stay on. If we trash them in the press, they’ll just trash us back. That’s what I’d advise them to do if I were working for them. (Which I’m not, by the way, just so we’re all on the same page.)
And the critics saying that the president has to show he’s mad? Ignore them. Who thinks the American people want a leader who will express impotent rage at the failures of his own administration? Also, let’s maybe not have the president say that people can call a 1-800 number and all will be well when they, um, can’t.
And please, don’t let anyone fall for the Republican line that Kathleen Sebelius has to go. If you’ve liked the way the last few days have gone, you’ll love how the hearings to confirm her successor at the Department of Health and Human Services would go. I think we need the folks at HHS to be thinking about fixing the site, not about that monkey court. (I do wish Sebelius hadn’t said we need a couple more years, though. We’re the ones who set the timetable, right?)
So basically everything I’ve been hearing our guys say has been a mistake. By now, though, you’re probably wondering what I want you guys to do instead. Here’s my advice: FIX THE [REDACTED] SITES!
Seriously, I don’t think there’s any other way out of this. If only highly motivated people -- people who would climb Mount Everest to get insurance -- sign up, we’re in trouble. Premiums will go up, which means that even fewer people will get insurance unless they’re subsidized. Plus the subsidies will get more expensive. None of this is what we promised when we passed this law.
And delaying the mandate to buy insurance (or whatever we call that -- the responsibility provision? -- I forget what we came up with) doesn’t fix that problem. It makes it worse. We would be giving healthy people one less reason to buy insurance, when the whole problem is that they’re not buying it.
I get that some of our friends on Capitol Hill are concerned about how things are going. Obviously I am, too. But they need to think this one through. If we delay the mandate/whatchamacallit, we’re going to be taking a big risk with the budget numbers and the enrollment numbers, and we’ll get even more Tea Party I-told-you-sos (which are already incredibly annoying). We’re in pretty bad shape, but I think we would have to be in even worse shape before we would do that. (Can we maybe get the Republicans to shut down the government again? That was great.)
So how do we fix this? Heck if I know. I do political strategy, not computer work. All I know is we’ve got to fix the sites. And maybe start lowering expectations for what the law is going to accomplish.
P.S. If this keeps going, overtime rates are going to apply for my team.
(Ramesh Ponnuru is a Bloomberg View columnist, a visiting fellow at the American Enterprise Institute and a senior editor at National Review.)
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