Editorial: Healing the Affordable Care Act’s sign-up system
When the Affordable Care Act was passed by Congress in 2010 and signed into law by President Obama, it was rightly hailed as a landmark achievement. It marked the most significant and sweeping change in domestic policy since Medicare, passed in 1965, created the federal program that provided senior citizens with health care coverage in their later years.
The Affordable Care Act represented the first successful effort to reform other aspects of the nation’s sprawling, expensive, inefficient and hideously complex health insurance system — notably the shameful fact that, alone among modern industrial countries, our system left some 40 million people without any coverage at all.
Previous presidents — as far back as Theodore Roosevelt and as recently as Bill Clinton — had supported changes, but had foundered in the face of opposition.
Which is why the administration’s bungled introduction of its website, healthcare.gov, and the backpedaling over the president’s repeated promises that “if you like the health care you’ve got, you can keep it,” have been painful — and infuriating — to watch.
The website’s failures and the messaging problems are self-inflicted wounds, mistakes the president’s supporters surely wish they could blame on the Republicans, but know they can’t.
The GOP, to be sure, has by no means acted as a loyal, responsible opposition. Republicans in Congress have sought to defund and obstruct reform at every step, and many Republican governors have refused the federal Medicaid money that would have been used to expand coverage for many low-income Americans.
The bottom line, though, is that predictable, relentless opposition made it all the more imperative for the administration to get the implementation of the Affordable Care Act right.
We’ll leave it to future historians to deconstruct how it happened that the website set up to enroll people in health care plans was launched before it was anywhere near ready — despite the knowledge that technology rollouts are rarely glitch-free, despite the fact that history shows that every major government program faces rough going in its early days and despite the fact that the foes of reform were ready to pounce on every problem.
It’s up to the administration to fix its mistakes — and to fight for the Affordable Care Act’s absolutely worthy provisions. If ever there was a time for a president to use the bully pulpit, it’s now.
We hope in coming days to see President Obama marshal his considerable talents to remind Americans that the goals of health care reform have not changed. He needs to show the public that changes already in effect — such as ensuring that people with pre-existing conditions aren’t denied coverage, and allowing adult children to remain on their parents’ policies — are working. He needs to see that people dealing with uncertainty and confusion about changes to plans they already have can find competent help. He needs to encourage young and healthy people to sign up for coverage, even though they may think they can get by without it. And he needs to see to it that those who lacked coverage in the past — many of whom are among the working poor — finally have access to decent care.
Failure to do so will only strengthen the hand of those who were callously willing to accept a system for so many years that failed so many.