Last spring, the Senate Finance Committee held a hearing on implementation of the Affordable Care Act, otherwise known as Obamacare. Sen. Max Baucus, a Montana Democrat and the chairman of the committee, was not pleased with how things were going.
The Obama administration originally had asked for more than half a billion dollars to spend on public relations and outreach for the law. House Republicans had returned with an offer of nothing. That’s right: zero dollars. Without necessary funds, the Department of Health and Human Services worried it would not have the necessary money to pay for navigators to help people enroll in health care, for the technology needed to implement the exchanges and for the public relations campaign that was required to inform citizens about what the law actually did.
HHS Secretary Kathleen Sebelius made the controversial move of asking insurance companies and nonprofit organizations to donate money and help. Republicans were outraged. She asked for more money. She was refused.
Federal legislators aren’t the only ones to blame. Let’s remember that original versions of the bill called for one big national exchange. This would have been much easier to implement. But conservatives declared that insurance should be left to the states and kept out of the hands of the federal government. So as a compromise (yes, those did occur), exchanges were made state-based instead of national.
As a precaution, the law stipulated that if states failed to do their duty and enact exchanges, the federal government would step in and pick up the slack. This was to prevent obstructionism from killing the law. Surprisingly, it was many of the same conservative states that demanded local control that refused to implement state-based exchanges, leaving the federal government to do it for them.
That made implementation much harder.
There have been books, webinars and meetings explaining how to sabotage the implementation of Obamacare. There have been campaigns trying to persuade young adults not to use the exchanges. It is, therefore, somewhat ironic that many of the same people who have been part of all of this obstructionism seem so “upset” by the fact that people can’t easily use the exchanges.
For goodness sake, the government was shut down just a few weeks ago because some of the same people who are now bemoaning poorly functioning websites were determined to see that not one dime went to Obamacare.
More from Aaron Carroll@ CNN
Posted by Libergirl