Obama Downplays Health Care Law Implementation Fears

President Obama downplayed the risks involved in the rollout of his health care law at a press conference today. Asked by MSNBC's Chuck Todd why Sen. Max Baucus (D-MT) believes the implementation might be a "train wreck," Obama suggested that the majority of the law's installation had already been successfully carried out:

So there are a whole host of benefits that -- for the average American out there, for the 85 to 90 percent of Americans who already have health insurance, this thing's already happened, and their only impact is that their insurance is stronger, better, more secure than it was before. Full stop. That's it. Now they don't have to worry about anything else.

The implementation issues come in for those who don't have health insurance, maybe because they have a pre-existing condition and the only way they can get health insurance is to go out on the individual market and they're paying 50 percent or a hundred percent more than those of us who are lucky enough to have group plans.

The president did hedge his bets, somewhat, warning that setting up the law's state-level health insurance exchanges would be a "big complicated piece of business" and that dealing with Republicans in Congress and in state capitals "makes it harder." He also predicted future "glitches and bumps" along the way to full enactment of the law.

Yet overall his reassurances did not rise to the level of the the concerns that have been raised by Baucus and other Democrats about implementation. Baucus, in particular, in his "train wreck" comments was asking Health and Human Services Secretary Kathleen Sebelius about the public's lack of understanding of the law. Those fears are not going away. A Kaiser Family Foundation poll released just today indicates that 40 percent of Americans are not aware that the law is on the books.

Even more importantly, Democrats' and others' worries that the implementation might not go according to schedule or as planned are well founded. John Harwood sketched out some of the immediate challenges the administration faces in yesterday's New York Times:Among the complex imperatives: pushing reluctant states to set up insurance marketplaces and expand Medicaid programs, keeping an eye on insurance companies as they issue new rate schedules, measuring the law’s effects on small-business hiring, and coaxing healthy young people to buy coverage so the system works economically for everyone else.

Even if the administration is able to manage all of those complex tasks before Congressional Democrats face voters in 2014, Republicans will be watching to pick up on any signs of malfunction. The Washington Times reports that Utah senator Orrin Hatch, the ranking Republican on the Finance Committee, is monitoring proposed rate plans from across the country for any sign of spiraling insurance premiums. In Harwood's New York Times piece, conservative economist N. Gregory Mankiw indicates that the GOP will be on the lookout for evidence that the law discourages lower-income worker from working longer hours. And Republicans will also watch for corporations or state and local governments shifting workers on the exchanges.

The challenge of the health care law's implementation is a real one. Obama may be able to downplay the size of the task for now. But that won't be a viable strategy as 2014 draws nearer for Democrats in the House and Senate, the laws' deadlines approach, and news continues to trickle out about "glitches and bumps" in the process.

Joseph Lawler is editor of RealClearPolicy. He can be reached by email or on twitter.

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