Here's the bottom line. The success of state insurance exchanges doesn't matter. Obama's naivete, or passiveness, or whatever, over how much extra lifting would have to be done on the federal exchange because of how many states that would refuse to set up state exchanges, doesn't matter.
The bottom line, put impolitely, is this. Senate Democrats want the damn thing fixed:
"There's only so much muddying up you can do on an issue as important as this," said Tom Bowen, former political adviser to Chicago Mayor Rahm Emanuel. "People elected politicians who disagree with them as long as they know where they stand. You have to have some flexibility, but trying to sort of shade who you are—that doesn't inspire a lot of confidence."That part of the quote after the "said" is also important. Beyond fixing the federal exchange website, too many workarounds, like telling people to go directly to private insurers, further muddies the waters. Reportedly, Obama is considering letting people do just that. I think that's idiotic.
Is the concern serious? Well, National Journal says it is:
Indeed, there's a growing sense of fatalism among Democrats. Even as strategists are advising their clients on how to best talk about health care, they badly want to change the subject and hope that the problems go away. On that point, the White House and congressional Democrats are on the same page.First, a sidebar. I've heard people claim National Journal is a right-wing website. Not even close. It's a bipartisan, inside-the-Beltway magazine, a long-form Politico with more brains. Go ahead and believe stuff like that if you want. Believe that the federal exchange website has been the target of politically driven DDoS attacks, while you're at it.
"If the election were held today, Republicans would probably win back the majority," said one longtime Democratic operative tracking internal Senate polling. "But we know for sure the election would not be held today."
And, then, if Senate Dems' worst fears come true, blame nobody but yourself for a head-in-the-sand posture.
Meanwhile, as of Nov. 27, Senate Dems may have yet another reason to worry. Dear Leader is delaying by a year small businesses' opportunity to hunt for employee coverage directly on the federal marketplace system. I'll stand by to see how Obamiacs explain away this one.
Yes, small businesses can still shop offline, via an insurance broker or directly with insurers, but, this issue also goes to credibility about whether alleged fixes to the federal exchange will work as well as administration claims.
And, as far as the political chess match issue, National Journal explains just why Senate Democrats are worried.
On the House side, Nancy Pelosi can say whatever she wants about Obamacare and standing behind it in midterms. Democrats are already the minority party in the House.
Finally, Nov. 30 is not the only looming date of concern.
There's another deadline. Dec. 23 is the deadline to sign up for insurance for the new year. Maybe Obama doesn't fully hit that target on software fixes either, as Amy Davidson notes at the New Yorker. She, too adds (this is the New Yorker, not the New York Post, folks) that much of the problem is Dear Leader's:
After five years in the White House, Obama still believes that he can go into a corner, tinker with something until it’s better, and win on the merits. The long view can serve him well, but it can also leave him unprepared when the other side won’t give up on an all-out battle. Health-care reform is the President’s signature legislative achievement, and a historic one. To preserve it, he needs to fight for it politically, state by state. This time, the Obama brand alone isn’t enough.Chances of him truly grasping that? C'mon, we've seen enough of him over five years. Chances are 50-50 at best.
My guesstimate? By Dec. 23, between improving but not totally fixing the federal exchange websites, and various workarounds, but only in federal exchange states, Obamacare there will get to about 75-80 percent of enrollment targets. Whether that becomes a glass half full/skin of his teeth, "win," or a glass half empty "loss," remains to be seen.
That, in turn, raises another issue. If the fix isn't perfect, will Senate Democrats up for election in 2014 want Obama campaigning with them or not? And, how much effort will he put into it?
And, for those of us who wanted single-payer national health care, the failure of Obamacare won't get us closer to that, sadly. Of course, neither will its success, at least not much closer.