Between October 1 and December 1, the nation witnessed the most remarkable reversal of political fortune in recent memory and what may prove to have been the collapse of the greatest achievement of progressive liberalism in our time. What happened during the first 61 days of the active life of the Patient Protection and Affordable Care Act—popularly known as ObamaCare—will be the focus of historical and political scrutiny for decades. Even at this close remove, though, it is worthwhile to recount the story of ObamaCare’s disastrous debut and the efforts to excuse the disaster before the scope and extent of the problems became impossible to dismiss.
On October 1, the Republican-led government shutdown—a misguided strategy aimed at preventing the implementation of ObamaCare—commenced at the same hour the law went into effect. Healthcare.gov, the website created to allow Americans to shop for different health-care plans, crashed the instant it opened. Even those predisposed to pardon ObamaCare found it necessary to express some exasperation at the inability of consumers to navigate the website. The most notable was MSNBC anchor Mara Schiavocampo, who threw up her hands in frustration on the air amid an effort to enroll in the insurance exchanges.
Health and Human Services Secretary Kathleen Sebelius insisted on the day after its debut that the website’s technical issues were a “great problem to have.” Only the demand of a prodigious multitude could force a website to seize up, she suggested; this was an indication that the public was obsessively interested in signing up for affordable health insurance.
While the White House acknowledged that a problematic website was frustrating their efforts to sign users up for private insurance plans, its spokesmen believed the interest level was so high that the website would actually succeed in registering more enrollees than originally predicted. But it seemed instantly peculiar that, given this claim, the administration refused to provide enrollment statistics. Later in October, Sebelius told Congress under oath, “We do not have any reliable data around enrollment, which is why we haven’t given it to date.”
Occasional anecdotes about successful enrollees emerged from the administration and friendly voices in the media, but each tale burned white hot in the press only for a short time, almost every one collapsing upon greater scrutiny. One such fable was that of 21-year-old Georgia native Chad Henderson. Claiming that he had successfully enrolled himself and his father in private insurance through the federal exchanges, Henderson was the subject of profiles by the Washington Post, the Wall Street Journal, Politico, the Huffington Post, and others. Only in alternative media outlets was it revealed that Henderson was a devoted Obama campaign volunteer and an Organizing for America activist. Within hours of his elevation to the national stage, Henderson’s father scuttled this widely circulated success story when he revealed to Reason magazine that he and his son had only been able to peruse their insurance options. Neither had successfully purchased anything.
Even as some Democrats, such as California Representative Adam Schiff, were lamenting the “lost opportunity” that ObamaCare supporters had squandered after the first week of implementation, the Washington press corps was still almost entirely focused on the story they preferred to cover: the government shutdown and the implosion of the Republican Party. The president was only too happy to play along. At a lengthy press conference on October 8, President Obama apologized to the nation for the GOP’s intransigence and declared that he and his fellow Democrats would refuse to give in to Republican demands to reform or reframe ObamaCare. “Lord knows, I’m tired of it,” Obama told members of the press corps, “but at some point, we’ve got to break these habits.”
What most did not yet realize, but what was known at the highest levels of the executive branch, was that a delay in the implementation of ObamaCare was badly needed. The flaws in the website were all but fatal. At the same time, Americans were being informed that their policies for 2014 were being cancelled and that they had to sign up for new ones through the website in time for January 1, healthcare.gov was useless for almost everyone, and time was melting away. That the White House did not avail itself of the perfect political opportunity to buy time while hiding behind a conciliatory accommodation to their critics suggested either hubris of the highest order or a kind of political panic—that any acknowledgment of the flaws in the system would help make the Republican case against ObamaCare.
As a second crisis over the government debt ceiling loomed and an atmosphere of crisis characterized the press coverage of the government shutdown, moderate Republicans finally convinced the party’s recalcitrant conservative wing to end it. Victorious, Obama again took to a podium in the White House and announced his intention to capitalize on his advantageous political position. But something had changed. Over the course of the shutdown, some media personalities and prominent reporters had said they would turn their attention to the ObamaCare rollout once the government reopened. “The problems with ObamaCare is something I would be covering much more if I weren’t covering the government shutdown and this threat of default,” CNN’s Jake Tapper said on October 10. Other reporters and media figures echoed this exculpatory refrain. Now those checks had come due.
Just before the end of the shutdown, a report spread through the press like brushfire that only 0.4 percent of visitors to the exchanges had actually been able to enroll in an insurance plan. On October 17, software-programming expert Luke Chung told reporters that the site “looks like it was created by someone who’s never delivered commercial software before.” He warned that, without a management shakeup, “this project is doomed.”
Beyond the website’s issues, reporters began to scratch the surface of the structural and conceptual maladies plaguing ObamaCare as a whole. CNN reporters traveled to low-income health-care clinics around the nation to see how the health-care reform law was being received. There, they discovered that low-income health-care consumers were appalled at the notion they would have to pay for health-care insurance. “It’s not clear just yet if any premium under the Affordable Care Act will be deemed affordable at all to the lowest income consumers,” CNN’s Drew Griffin reported.
The media’s shift in focus coincided with a tsunami of cancellations—insurance companies informing their customers that the policies they had previously held could no longer be sold owing to new ObamaCare regulations. Thousands of notices became tens of thousands, then hundreds of thousands. It soon became clear that this purging of the insurance market was occurring by design, and that there would be millions of newly uninsured before the process was complete.
Associated Press White House correspondent Julie Pace warned on October 20 that Obama had to accept the blame for ObamaCare’s failure to meet the expectations he had set for it. “There have always been charges from the right that the president’s health-care promises didn’t turn out to be true. But then some of those charges turned out to have some merit,” CBS News political director John Dickerson declared on October 21, warning that the president himself may be entering a “credibility death spiral.”
The coming days would see NBC’s Chuck Todd probing White House Press Secretary Jay Carney during the afternoon press briefing at the White House about who in the administration had “misled” the president. Mara Liasson, NPR’s national political correspondent, asked Carney whether the White House—which had recently tasked former Office of Management and Budget Director Jeff Zients with overseeing the website’s emergency repairs—would hold daily briefings as they had with “a natural disaster like the oil spill.” In an interview with Sebelius on October 23, CNN’s Sanjay Gupta pressed her to reveal whether she had considered resigning over the fiasco.
As the pressure on Democrats to explain ObamaCare’s failures increased, the resolve the president’s party in Congress had shown during the shutdown to defend it at all costs began to falter. By October 20, just four days after the government had reopened, House Minority Leader Nancy Pelosi repudiated Sebelius’s “good problem to have” narrative when she said that the glitches on the insurance exchange website were “unacceptable.” On October 22, New Hampshire Senator Jeanne Shaheen joined West Virginia Senator Joe Manchin in calling for a delay of the individual mandate’s penalties; she said it would be an “extension” of the open enrollment period. Three days later, she was joined openly by 10 of her Democratic Senate colleagues seeking reelection in 2014.
The White House sensed the need to stem the brewing tide of revolt from within Democratic ranks. On October 21, flanked by 13 ostensible ObamaCare beneficiaries, President Obama staged a press conference in the Rose Garden. He acknowledged the problems with the website but insisted that anyone who wanted could still enroll with a simple phone call. Fact-checking of the president’s statements would prove embarrassing. The 1-800 number the president twice told Americans to call did not work; its operators were required to enter the personal information they collected into a non-functioning website. Of the 13 people who stood behind the president on that day, by the White House’s admission, only three had successfully enrolled in private insurance through the exchanges.
The next week would see the press abandon the notion that the website’s problems would be resolved quickly. When former President Bill Clinton asserted that the public should “not worry” about the site’s issues, MSNBC host Joe Scarborough called his comments “grasping” and “a stretch.” NBC’s David Gregory assailed the website as a “caricature of incompetence.” Even Comedy Central host Jon Stewart had turned; on October 28, the popular comedian mocked the president’s “total ignorance” of what his own administration was doing.
By the beginning of November, concern within Democratic ranks had transformed into alarm. National Journal editorial director Ron Fournier revealed that a “senior Democratic consultant” had informed him in a series of expletives that the party itself might be doomed by the scale of ObamaCare’s failure.
Internal White House memos surfaced indicating that ranking administration members had indeed been informed that the website was not ready for its debut, and that the site’s users faced serious risks when they entered personal information. This was confirmed when a memo authored by Marilyn Tavenner, the head of Medicare and Medicaid Services, was uncovered by reporters; not only was the website design and execution inept, the memo said, but using it posed a threat to the security of a consumer’s most personal data.
Most damning, reports revealed that both Obama and his advisers were perfectly well aware that the ACA’s coverage requirements would force insurance providers to cancel millions of plans. This meant the president had knowingly misled the public throughout the year and as late as September 25 when he regularly claimed that anyone who wanted to could “keep your plan” and “keep your doctor.”
Amidst the roiling anxiety overtaking Democratic ranks, President Obama traveled to Boston on October 30 to hold a pep rally of sorts for his health-care act. Before a crowd of supporters, the president blamed “bad apple” insurance providers for cancelling millions of “substandard plans.” (This rather outrageous effort at spin was later dismantled by the Washington Post’s Glenn Kessler, hardly an unfriendly reporter.) Obama informed the newly uninsured public to “just shop around on the new marketplace,” even though he knew most would find this an impossible task.
The president’s efforts were met with criticism not from Republicans but from Democrats, who expressed annoyance at Obama’s continuing attempts to pin the blame for the crisis on Republicans, insurance companies, and any other scoundrel he could come up with. “The problem is we’ve got to deliver this. It has entirely to do with Democrats. The Republicans are irrelevant to this debate,” said former Vermont Governor Howard Dean. When asked about Obama’s waning credibility, one unnamed Democratic senator told Politico reporters, “You got to have it to lose it.”
While most Democrats had adopted an air of remorse when talking about ObamaCare by this stage, a few remained defiant. “There was nothing about what President Obama, or that I, or any other Democrat supporting the Affordable Care Act said that was not true,” Democratic National Committee chair and Florida Representative Debbie Wasserman Schultz maintained, employing a sufficient number of negatives to render this statement impervious to fact-checking.
On the night of November 7, Obama apologized to the nation again in an interview with NBC’s Todd. This time, however, he was not striking a melodramatic, more-in-sorrow tone about Republicans. Nor did he seek to shift the blame for the waves of cancelled insurance plans onto insurance companies or the GOP. Nor did he attempt to convince the public that their cancelled plans were “substandard.” Instead, Obama sounded a note of contrition—a note that would only grow louder in the coming days. “I am sorry that they are finding themselves in this situation based on assurances they got from me,” Obama said of those who had believed him when he said anybody who liked his plan could keep his plan. “We’ve got to work hard to make sure that they know we hear them and we are going to do everything we can to deal with folks who find themselves in a tough position as a consequence of this.”
The apology by the president of the United States to the American people was conspicuously absent from the front page of the following day’s New York Times.
The White House may have believed that an apology would be sufficient to quell public anger and stem the surge of Democrats insisting that the immediate pain of the debut be mitigated. Clearly, Obama and his team hoped to ride out the storm without altering the law. As late as November 12, Jay Carney stated that the White House did not support bipartisan efforts to allow those who had lost plans that did not meet the ACA coverage requirements to repurchase them.
This position proved untenable. Politico’s Jake Sherman revealed that virtually every Democratic senator up for reelection in 2014 and up to 100 House Democrats planned to defect on the issue. They would even support GOP initiatives that would allow new plans to be sold that did not meet ObamaCare requirements in perpetuity—which would effectively have destroyed the law from inside. On November 12, CNN’s Dana Bash reported that the White House had until the 15th to stop the bleeding and prevent a Democratic rout on Capitol Hill.
The administration stalled. On the 13th the White House finally released statistics showing how many had signed up for the ACA’s exchanges in October. The figures were dismally low; about 100,000 people had registered, and most of them not for private insurance but for Medicare. The following day, the administration caved. During a nearly 90-minute press conference, a chastened president conceded that the debut had been exceedingly frustrating and there was no excuse for its failures. He said his administration was learning that “buying insurance is hard” and that what they had asked of the public was “almost like we said to folks you’ve got to buy a new car even if you can’t afford it right now.” Obama added that he would request, but not mandate, that insurers reissue cancelled polices. But in doing so, he was preventing nervous Democrats from getting to register a vote against ObamaCare to take home to their constituents.
In subsequent days, still more memos popped up, revealing that Sebelius herself was warned in April that the website would fail. Meanwhile, measures taken to delay the harm imposed by ObamaCare on the insured and uninsured public were forcing the White House to prepare for a gigantic bailout of the insurance industry—one of many provisions contained within the extensive law that had been overlooked by the press. The Department of Justice had produced a memo in October, obtained by National Review, which warned that “a majority of group health plans will have lost their grandfathered status by the end of 2013.” In addition, a Centers for Medicare & Medicaid Services official testified before Congress that up to 40 percent of the already non-functional website had yet to be built.
Polls were showing a dramatic political reversal under way, with public support for the president and his signature achievement in free fall. But that was not the most terrifying revelation of the surveys; rather, it was that Democrats were abandoning the law as well. A CBS News/New York Times survey released on November 20 revealed that only 58 percent of Democrats supported the ACA, down from 74 percent a month prior. Seventy-two percent of Democrats said that the law needed substantial reform.
Early on in the debacle, the White House had set November 30 as a deadline to ensure that the website functioned for all users. When it became clear that such a goal would be impossible to meet, administration officials qualified the objective, saying they would be satisfied if only 80 percent of users experienced reasonable functionality. Wags pointed out that Amazon would hardly stay in business if it failed to fulfill one-fifth of its orders.
Moreover, journalists began to express resentment with how they had been manipulated by the administration. “The lack of answers from CMS…is pretty telling,” the openly liberal Huffington Post reporter Sam Stein conceded. “Frustrating,” wrote Washington Post health-care reporter Sarah Kliff.
On December 1, the White House announced it had met the arbitrary goals it had previously declared would demonstrate success in fixing the website, but even outlets such as National Public Radio derisively observed that the White House had to be taken at its word—a dubious proposition by this point even to Obama boosters such as the Washington Post’s Ezra Klein.
By December 2, it was obvious that the government had again overpromised. Thousands of website users were directed to a new “queue” that was created during the triage process to facilitate massive waiting times. After waiting for hours, users might have the privilege of entering their personal health and financial information into a dangerously unsecured data hub. The New York Times reported that the website’s “back end” was still skeletal. The “back end” is the catch-all term for the website’s unseen digital machinery; if it wasn’t working, then the website’s functionality was basically a visual illusion.
Reporters began to express their frustration with officials who refused to answer questions regarding the back end and its inability to translate user data to insurance providers. This so-called 834 issue threatened to create chaos in the new year as millions of ACA enrollees discover only after a visit to the doctor that they do not, in fact, have private health insurance. By December 3, the Real Clear Politics “poll of polls” showed Obama’s job approval below 40 percent for the first time in his presidency. His disapproval number was at nearly 56 percent, an all-time high.
Thus went the first two months of ObamaCare.
Just before the government reopened in mid-October, some pundits were contending that the GOP’s misbehavior had ironically restored America’s faith in the competency of federal government. “Government—if you look at some of these polls—government has grown more popular,” CNN chief political analyst Gloria Borger opined in mid-October. She could not have been more wrong; over the past five years, the federal government as a whole has grown steadily and relentlessly more unpopular; any slight turnaround in the days following the shutdown is nothing more than a blip. Still, she had a lot of company in holding that opinion, not least the man who sits at the desk in the Oval Office. He once wrote a book about the “audacity of hope.” That is a quality he will need following this crucible of his own devising, a crucible that is far from over, for him and for Americans who must now navigate their way through the wreckage.