Obama Tries to Avoid Health Care ‘Train Wreck’

President Obama was on the defensive during much of Tuesday’s White House press conference, but he pushed back at NBC’s Chuck Todd’s question about worries over implementation of the Affordable Care Act.

…For the 85 to 90 percent of Americans who already have health insurance, they’re already experiencing most of the benefits of the Affordable Care Act even if they don’t know it.

So all the implementation issues that are coming up are implementation issues related to that small group of people, 10 to 15 percent of Americans,..who don’t have health insurance right now.

And what we’re doing is we’re setting up a pool so that they can all pool together and get a better deal from insurance companies…That’s it. I mean, that’s what’s left to implement, because the other stuff has been implemented and it’s working fine.

If only it were that easy.

A couple of weeks ago, retiring Sen. Max Baucus (D-Mont.), who was instrumental in drafting health care reform, warned Health and Human Services Secretary Kathleen Sebelius that implementation could be a “huge train wreck.” Proposed insurance exchanges are slated to open in October.

President Obama answers questions at an April 30th White House press conference. Source: YouTube/whitehouse.gov.

President Obama answers questions at an April 30th White House press conference. Source: YouTube/whitehouse.gov.

Politico reports that “Democrats are worried now — about the messaging and the mechanics of the rollout”:

“I’m concerned — because we did take substantial criticism for putting this plan in place — that it achieve its true purpose,” said Rep. Lloyd Doggett of Texas. “There’s so much work to do in such a short period of time.

And there’s good reason for concern, John Harwood reported in The 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.

Only about half of the states have indicated that they will expand Medicaid under the law, a central ingredient for the goal of providing coverage to those now uninsured.

Of course, many states that haven’t expanded Medicare are run by Republican governors. The GOP sees little political advantage in helping make the law work.

And already some of the law’s quirks are actually driving premiums up, by 25-50% in some states.

Daniel Kessler of Stanford and the conservative Hoover Institution laid out a litany of possible woes for Obamacare in Tuesday’s Wall Street Journal:

The unpopular health-care law’s rollout is going to be rough. It will also administer several price (and other) shocks to tens of millions of Americans.

..Around six million of the 19 million people with individual health policies are going to have to pay more—and this even after accounting for the government subsidies offered under the law.

I estimate that another 10 million people, the approximately two-thirds of the market that is low- or average-risk, will see higher insurance bills for 2014.

 In total, it appears that there will be 30 million to 40 million people damaged in some fashion by the Affordable Care Act—more than one in 10 Americans.

On Tuesday, the president assured the nation that “we are pushing very hard to make sure that we’re hitting all the deadlines and the benchmarks.”

That’s hardly reassuring from a president whose follow-through often has fallen short of his lofty rhetoric. Given the difficulties in getting his second-term agenda through Congress, President Obama’s place in history may rest on the success or failure of health care reform.

That’s why this time he needs to sweat the details and be prepared to sell health care reform yet again.

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