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The President is Failing the Leadership Test on Health Care Reform


Recent announcements of major delays in implementing key parts of the law demonstrate the Affordable Care Act is fundamentally flawed.

The most recent Rasmussen Reports daily Presidential Tracking Poll shows that nearly half of respondents (49%) disapprove of President Obama’s job performance, with 38% strongly disapproving.

A major driver of this is the ongoing fiasco surrounding the preparations for full implementation of the Affordable Care Act (ACA). In recent weeks the public has learned just how unprepared and adrift this administration is when it comes to its signature legislative achievement, with two stunning revelations that hint at the disaster that awaits us in 2014 and beyond.

First, we learned that the Obama administration was postponing for at least a year the requirement that businesses with 50+ employees have to offer insurance coverage or pay hefty fines ($2,000 per employee after the first 30). The Administration claimed it has been “engaging in a dialogue with businesses… about the new employer and insurer reporting requirements under the Affordable Care Act,” during which it “heard concerns about the complexity of the requirements and the need for more time to implement them effectively.” Because of this, it decided to delay the mandatory employer and insurer reporting requirements until 2015, which will allow the feds to “consider ways to simplify the new reporting requirements consistent with the law” and also “provide time to adapt health coverage and reporting systems while employers are moving toward making health coverage affordable and accessible for their employees.”

Then came the announcement that health insurance marketplaces will not be required to verify consumer claims about income and insurance status when applying for subsidies. Under the ACA, people who earn less than 400% of the federal poverty guideline (which is about $46,000 for an individual) are eligible to receive tax subsidies to purchase health insurance on an exchange. Also, people who are not offered affordable health coverage by their employer are also to receive tax credits. For the insurance exchanges and the subsidies to work, and in order to be able to estimate and track the costs of the program, it is imperative that the government be able to determine who qualifies to receive assistance.

However, the Washington Post reported that “the federal government will rely more heavily on consumers’ self-reported information until 2015, when it plans to have stronger verification systems in place.” Due to “legislative and operational barriers,” the feds will not require states that are running their own insurance exchanges to verify consumers’ claims that they do not receive health insurance from their employer. The feds have also “scaled back states’ responsibilities to double-check the income levels that consumers report, which determine any tax subsidy they receive.” Now, instead of auditing every person whose claims regarding their income don’t match with federal records (ie, the IRS), states will only audit “a statistically significant sample of such cases.” This is reminiscent of the mindset that gave us “liar loans” and the subprime mortgage debacle.

At every turn, the ACA has been a disaster before it even takes full effect. The politicians and bureaucrats in charge of designing and implementing this law have had three years to get this right, but are proving time and again they have no idea what they’re doing: higher than anticipated costs, major delays in reporting and monitoring provisions, insurers opting to not participate in key state exchanges—there was even a “computer glitch” that will prevent insurance companies from charging smokers higher premiums. The list of errors and failures grows every week. The old adage “The devil is in the details” has merit.

As Senator Mike Enzi (R-WY) recently observed, the ACA “is so massive, burdensome, bureaucratic and confusing that it’s collapsing under its own weight.” Opponents of the law have predicted this failure from the beginning. Unfortunately, this administration and its supporters on Capitol Hill are determined to forge ahead, despite that fact that, to quote Enzi again, “All across the country health insurance rates are skyrocketing. Employees are losing coverage through their employers. Families are struggling to cope with higher costs and less choice. Businesses aren’t hiring full-time employees.”

Polls show that 50% of Americans have an unfavorable opinion of the ACA, with 38% viewing it “very unfavorably.” Rather than reach across the aisle to pursue sensible bipartisan reforms to this law and prevent this rapidly unfolding disaster from getting worse, the President is instead doubling down and taking every desperate (and possibly illegal) measure he can to foist this on an increasingly skeptical public. Technical incompetence plus partisan pursuit of unpopular goals equals a President who is failing the biggest leadership test of his life.

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