Is Obamacare on a death spiral? Too early to say, but it doesn’t look good

2013-11-18T03:00:00Z 2013-11-18T14:01:03Z Is Obamacare on a death spiral? Too early to say, but it doesn’t look goodPolitics & You by Mike Dennison Montana Standard
November 18, 2013 3:00 am  • 

HELENA — Seven weeks into the roll-out of the “Obamacare” marketplace and other key elements of the president’s signature health-care law, I think we can all agree: It’s one colossal screw-up by the Obama administration, and could end up sinking the whole law and his presidency.

Team Obama is struggling mightily to right this ship, but once large parts of the public start doubting your credibility and competence, it’s hard to recover. Just ask George W. Bush and Jimmy Carter about that one.

Can Obamacare be patched up and made to work as its supporters imagine? I wouldn’t even venture a guess at this point. But before we address that question further, let’s consider a couple of things about the law, its intent and its politics.

For starters, the botched online marketplace and individual and small-group policy cancellations in the news affect a relatively small sector of the population and health-insurance market.

In Montana, only 55,000 people are covered on the individual market. State insurance regulators estimate about half of them – 26,000 — received or will receive notices saying their current policy is being discontinued, and that they must buy new policies that comply with the Affordable Care Act (Obamacare).

The president is saying those policies now can be extended, although we’re not sure yet that will happen in Montana.

If it doesn’t, some people will end up paying more for a new policy. However, some also should be able to shop the online marketplace – if it ever works – and find a new affordable policy and, perhaps, one that is discounted by a subsidy.

People without health insurance, such as those who couldn’t afford it or who had pre-existing health conditions that got them rejected by insurers, also now are supposed to be able to shop for policies on the online marketplace. In Montana, this group could be as many as 100,000 people.

Some who are insured by small-group policies also may be affected by Obamacare in some way, such as having their employer drop coverage, pushing them onto the marketplace.

So, at most, 15 percent to 20 percent of Montana’s population could be directly affected by the fumbled roll-out and accompanying regulations. That’s no small amount of people, but it still leaves at least 80 percent largely unaffected and insured, covered by the likes of large-group policies, Medicare and Medicaid.

The president also said last week the screw-up is “on me.” Yes, it is. But Republicans should share the blame, too.

It’s true that Republicans didn’t vote for Obamacare, opposed it from the beginning and said it wouldn’t work.

It’s also true that since the law was passed by Democratic majorities in Congress, most Republicans and their allies have tried relentlessly to undermine, sabotage and undo the law, and, in many cases, spread misinformation about it.

Take the online marketplace in Montana, for example. Insurance Commissioner Monica Lindeen, a Democrat, asked the 2011 Legislature to authorize the state to design and run the marketplace. She had the support of major health insurers and agencies, many in the business and medical community and consumer advocates. The Republican majority in the Montana Legislature said no.

That left the federal government to build and operate Montana’s online marketplace. It’s been a disaster so far.

States that did design and run their own marketplace haven’t been a paragon of efficiency, but many are doing better than states that defaulted to the federal website. Montana could have been one of the former, giving its citizens a better chance to shop for private and possibly discounted insurance.

Republicans also have pretty much refused to help fix problems with the ACA, instead saying the only answer is to repeal it.

Amid all the political noise over the ACA, it’s worth repeating the goal of the law: To expand health coverage to the 50 million Americans without it, and improve private and public health insurance, and medical care in general, while it accomplishes that goal.

I doubt many among us think these goals are unworthy. The question becomes, can the ACA accomplish those goals, and at what cost – and does it deserve a chance to succeed?

That’s where the president and his supporters have to sell the public on this thing – and I’ve always thought it was a pretty tough sell.

Yes, the ACA helps the poor and the unhealthy get insurance coverage (although even that’s somewhat in question, with the messy roll-out of the marketplace and the lack of Medicaid expansion in many states) and has some protections for insurance consumers.

But, for most of us, we’re still paying dearly for medical care and health coverage, still dealing with a maddeningly complex and expensive system, and paying, indirectly or not, for the costs of Obamacare.

If the president and ACA supporters can’t convince us — or, more importantly, show us — that the law is somehow benefiting a majority of Americans, then public support will continue to flag. Without public support, the ACA is doomed, and could take years to unravel.

Obama and friends had better hope they get things fixed, and change the narrative. It won’t be easy.

Mike Dennison is a reporter for Lee Newspapers State Bureau. He can be reached by phone at (406) 447-4068 or at (800) 525-4920 or at or by email at mike.dennison@lee.net .

Copyright 2015 Montana Standard. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

(9) Comments

  1. Dagtag
    Report Abuse
    Dagtag - November 19, 2013 4:34 pm
    Is Obamacare on a death spiral?

    Let's hope so! Hopefully this disaster will occupy so much of the blamer in chief's time over the next three years that he won't have time to destroy anything else.
  2. jimnbubba
    Report Abuse
    jimnbubba - November 18, 2013 11:39 am
    By not liking the ACA is falsehoods about it ? It was passed by Democrats who never even read the bill
  3. jimnbubba
    Report Abuse
    jimnbubba - November 18, 2013 11:37 am
    We did all his ? Or was it the taxpayers ?
  4. jimnbubba
    Report Abuse
    jimnbubba - November 18, 2013 11:35 am
    That is fine if you want to live in a socialist country. Perhaps those people should move to a country with free healtcare for all, but he botom line is nothing is free ,someone has to pay for it
  5. icesk8er
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    icesk8er - November 18, 2013 10:08 am
    Obamacare is a death spiral.
  6. McQueen boy
    Report Abuse
    McQueen boy - November 18, 2013 9:15 am
    "Republicans should share the blame too". You have got to be kidding me. How can one forget the Dems totally locked the Repubs out of designing and conceiving this nightmare, not to say not one republican in either the house or Senate voted for Obamacare. By the way good or bad, it will always be remembered as Obamacare as the president himself has many times referred it as such. Also no one but the president himself should take the biggest share of blame for spreading false information... If you like youre health insurance and doctor you can keep them.PERIOD. I have a relative and friends who received the cancellation notices( I know it's only a small percent and they really don't count), this situation is real and no spin can make it better.
  7. Silverhio
    Report Abuse
    Silverhio - November 18, 2013 9:01 am
    Our current health care "system" is a dreadful shame, staffed by wonderful people who see the insanity of it all every day. How can we be a great nation with such a large percentage under or not insured? As it is, we fear this health care system so much that many won't go to the doctor because they cannot even afford the copays even with insurance. Thousands show up for free tent health clinics, refugees trying to survive or get by without regular health care. It is shocking to contrast this situation with the concerns over obamacare, the broken, slow website for the 10 percent who will now be able to buy insurance no matter what. The headline on this piece is outrageous in this context. Seven weeks and condemn any change?
  8. zubie41
    Report Abuse
    zubie41 - November 18, 2013 8:40 am
    To quote the Billings Gazzette; "The idea of spreading liability among all insured makes sense". That idea , along with keeping kids insured longer, doing away with pre-existing condition clauses and coverage caps and just plain offering health insurance to millions that have never had it. We put a man on the moon, spent trillions on wars of dubious merit and won't do this? I can't believe it.
  9. Ricky Light
    Report Abuse
    Ricky Light - November 18, 2013 4:06 am
    property, land, township in jaipur,ace group, ace town planners, celebrity city, shree city
    land for sale

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