The Obamacare sabotage campaign
By: Todd S. Purdum
November 1, 2013 05:04 AM EDT
To the undisputed reasons for Obamacare’s rocky rollout — a balky website, muddied White House messaging and sudden sticker shock for individuals forced to buy more expensive health insurance — add a less acknowledged cause: calculated sabotage by Republicans at every step.
That may sound like a left-wing conspiracy theory — and the Obama administration itself is so busy defending the indefensible early failings of its signature program that it has barely tried to make this case. But there is a strong factual basis for such a charge.
From the moment the bill was introduced, Republican leaders in both houses of Congress announced their intention to kill it. Republican troops pressed this cause all the way to the Supreme Court — which upheld the law, but weakened a key part of it by giving states the option to reject an expansion of Medicaid. The GOP faithful then kept up their crusade past the president’s reelection, in a pattern of “massive resistance” not seen since the Southern states’ defiance of the Supreme Court’s Brown v. Board of Education decision in 1954.
The opposition was strategic from the start: Derail President Barack Obama’s biggest ambition, and derail Obama himself. Party leaders enforced discipline, withholding any support for the new law — which passed with only Democratic votes, thus undermining its acceptance. Partisan divisions also meant that Democrats could not pass legislation smoothing out some rough language in the draft bill that passed the Senate. That left the administration forced to fill far more gaps through regulation than it otherwise would have had to do, because attempts — usually routine — to re-open the bill for small changes could have led to wholesale debate in the Senate all over again.
But the bitter fight over passage was only the beginning of the war to stop Obamacare. Most Republican governors declined to create their own state insurance exchanges — an option inserted in the bill in the Senate to appeal to the classic conservative preference for local control — forcing the federal government to take at least partial responsibility for creating marketplaces serving 36 states — far more than ever intended.
Then congressional Republicans refused repeatedly to appropriate dedicated funds to do all that extra work, leaving the Health and Human Services Department and other agencies to cobble together HealthCare.gov by redirecting funds from existing programs. On top of that, nearly half of the states declined to expand their Medicaid programs using federal funds, as the law envisioned.
Then, in the months leading up to the program’s debut, some states refused to do anything at all to educate the public about the law. And congressional Republicans sent so many burdensome queries to local hospitals and nonprofits gearing up to help consumers navigate the new system face-to-face that at least two such groups returned their federal grants and gave up the effort. When the White House let it be known last summer that it was in talks with the National Football League to enlist star athletes to help promote the law, the Senate’s top two Republicans sent the league an ominous letter wondering why it would “risk damaging its inclusive and apolitical brand.” The NFL backed off.
The drama culminated on the eve of the open enrollment date of Oct. 1. Congressional Republicans shut down the government, disrupting last-minute planning and limiting the administration’s political ability to prepare the public for the likelihood of potential problems, because it was in a last-ditch fight to defend the president’s biggest legislative accomplishment.
“I think my Republican colleagues forget that a lot of people are enrolling through state exchanges, rather than the federal exchange,” Rep. Frank Pallone (D-N.J.) noted last week. “And if it wasn’t for the fact that many Republican governors, including my own,” failed to set up state exchanges, “then we wouldn’t be putting so much burden on the federal system.”
In fact, putting an excessive burden on the federal government was the explicit aim of the law’s opponents. “Congress authorized no funds for federal ‘fallback’ exchanges,” the Tea Party Patriots website noted as long ago as last December. “So Washington may not be able to impose exchanges on states at all.” The group went on to suggest that since Washington was not equipped to handle so many state exchanges, “both financially and otherwise — this means the entire law could implode on itself.”
That same month, the conservative pollster and pundit Dick Morris urged visitors to his website to sign petitions asking their states to refuse to establish exchanges. “If states assume the responsibility for administering this nightmare,” he warned, “the blame will not land on the president’s doorstep.”
In congressional testimony this week, HHS Secretary Kathleen Sebelius declined to blame the paucity of state exchanges for the system’s problems. “We should have anticipated, we should have planned better, we should have tested better,” she said.
But just last week, Rush Limbaugh advised his listeners that they could avoid penalties for failing to buy mandated insurance by arranging to avoid federal income tax refunds, since the IRS can only levy fines by withholding refunds, not by liens or criminal sanctions.
The conservative battle against the Affordable Care Act continues on multiple fronts — including, again, in the courts. A federal district court judge in Washington last week denied the government’s motion to dismiss a lawsuit filed by individuals and businesses from six states. The suit, coordinated by the Washington-based Competitive Enterprise Institute, challenges an IRS ruling that people can get tax credits to subsidize insurance in the federal-run exchanges, not just the state-based ones. Knocking out those subsidies would be a huge blow to the heart of Obamacare’s coverage expansion. Similar cases are pending in other states.
Meantime, Darrell Issa, chairman of the House Committee on Oversight and Government Reform, sent letters last week to Google, Microsoft, Verizon, Oracle and Expedia, demanding to know if they were among the Silicon Valley experts enlisted by the Obama administration to help fix the sputtering health care website. He asked them to “provide all documents and communications referring or relating to any contact” they may have had with the administration or contractors working on the problem since Oct. 1.
And a health expert at the libertarian Cato Institute has drawn up an action plan on how to keep fighting the law in the states.
For months, the White House has hoped that every politician’s instinct to render effective constituent service would trump political resistance to the law among Republicans. Even that has proved doubtful. Rep. Tim Huelskamp (R-Kan.) said last summer that his office would not provide assistance in signing up for the law. “Given that we come from Kansas,” he said, “it’s much easier to say, ‘Call your former governor,” meaning Sebelius. “You say, ‘She’s the one. She’s responsible.’’’
Obama himself has occasionally expressed frustration at the GOP’s implacable resistance to even the smallest gestures of cooperation on the law.
“In a normal political environment, it would have been easier for me to simply call up the speaker and say, ‘You know what, this is a tweak that doesn’t go to the essence of the law.’ It has to do with, for example, are we able to simplify the attestation of employers as to whether they’re already providing health insurance or not. ‘It looks like there may be some better ways to do this. Let’s make a technical change to the law.’
“That would be the normal thing that I would prefer to do,” the president said. “But we’re not in a normal atmosphere around here when it comes to Obamacare.’’