July 9 2013
Do You Ever Think ObamaCare May Be Too Complicated to Implement?
If the Supreme Court had secretly wanted to help the Obama administration, perhaps the best favor would have been finding ObamaCare unconstitutional.
ObamaCare would have then become the dream almost come true, shot down by a court that would have been declared biased. The Democrats could have then gone back to the drawing board and tried to produce a different version. Judgment Day would have been delayed.
Did the administration have no inkling when the law was passed that implementing it would be a fiasco?
It may not have known at the outset, but, according to a story in National Journal, the Obama administration has known for several months that it will not be able to implement the law as it was voted on by Congress.
As far back as March, a top IT official at the Department of Health and Human Services said the department's current ambition for the law's new online insurance marketplaces was that they not be "a Third-World experience."
Several provisions had already been abandoned in an effort to simplify the administration's task and maximize the chances that the new systems would be ready to go live in October, when customers are supposed to start signing up for insurance.
National Journal provides an incredibly complicated chart showing how the state exchanges are supposed to work. Lest you lose heart and refuse to attempt to decipher the chart, National Journal encouragingly observes, “Bear in mind, this chart is supposed to simplify and explain.”
If you can’t follow the chart—and I certainly couldn’t—the story explains:
In an ideal world, the exchange websites need to be able to talk to several federal agencies—IRS to verify an applicant's income and employment status, the Department of Homeland Security to determine her citizenship, and the state government to see if she qualifies for Medicaid, to name a few—all in real time, so a person could fill out a form and purchase insurance in one sitting.
Each of those departments has its own computer system and its own means of tracking information. Creating a "data hub" to share them has been a challenge, as a recent Government Accountability Office report highlighted. It is increasingly clear that the kind of Amazon.com, one-stop shopping that was once described – and that Obama himself referenced in a speech on Monday -- will not be available in most parts of the country.
"It's the joyous, simultaneous, nonlinear equation from hell," said Kip Piper, a former top official at HHS and OMB who is now a consultant in close contact with IT vendors. Piper said it's no surprise that the administration has given up on certain functions given the technological complexity needed and the short time-frame.
Of course, reading the law before voting might have given even supporters pause. All of this complexity was embedded right there in the 2,000 plus piece of legislation that Congress passed virtually unread. I’d be inclined to say, “Serves them right,” exceptthat it is the American public that is going to suffer.
By the way, the National Journal story doesn’t exactly take this tact: it admits that the administration is currently stymied but adds that things are likely to work out well:
The struggles with technology and administrative complexity have not come as a recent surprise to administration officials; they've been negotiating them for months already. By eliminating non-essential tasks, they may be violating the letter of the health reform law, with its rigorous timetables and multiple requirements, but they may be more likely to get the core functions right.
Love that “letter of the health reform law” bit. Actually, it’s more than the letter of the law the administration is changing—the administration is unilaterally changing the law. In the American system of constitutional law, presidents have not been able to suspend laws when it suits them. Pre-1688 English kings—yes—but American presidents? No, a resounding no.
And let’s not be too sure that delaying will do anything more than prevent a day of reckoning.
Again, the administration has had three years to figure out how to charge smokers a higher rate. Insurance companies have done this for much longer than that; how difficult could it be?
If the Obama administration is this incompetent at running its highest priority, just how badly are they bungling everything else?