Here are two things I learned today about Obamacare: it’s getting more popular, and it’s working reasonably well in Kentucky, a state that went for Romney over Obama by sixty to thirty-eight per cent.
According to a new Gallup poll, forty-five per cent of Americans approve of the health-care reforms, up from forty-one per cent in in August, even though the new poll was taken in the midst of all the publicity about the disastrous rollout of the Web site for the national insurance marketplace. That change is within the margin of error, but as Gallup put it, “The results suggest that the problems with the health exchanges have not negatively affected Americans’ overall views of the law, at least to this point.”
The news from the Bluegrass State came from Congressman John Yarmuth, who represents a Democratic district in Louisville. At a much-anticipated hearing of the House Energy and Commerce Committee devoted to the problems that the federal online insurance exchange has experienced, Yarmuth relayed some figures from Kentucky, which is one of the seventeen states operating its own exchange. (Despite going Republican in the Presidential election, Kentucky has a Democratic governor and legislature.) In its first three weeks of operation, Yarmuth said, the Kentucky site has had two hundred and eighty thousand unique visitors. Forty-seven thousand applications for insurance policies have been initiated, and thirty-three thousand and seven hundred have been completed. Eighteen thousand three hundred and seventy Kentucky residents have successfully enrolled in new policies.
Yarmuth read out messages he had received from two of these new enrollees. One of them, a sixty-two-year-old man who recently lost his job after thirty-eight years and was relying on expensive COBRA coverage, had signed up for a new plan that saved him eight hundred dollars a month. The other, a former cancer patient who had racked up hundreds of thousands of dollars in medical bills, had taken advantage of the provision of the Affordable Care Act that prohibits insurers from excluding people with preëxisting conditions, and had signed up for a new policy with no annual or lifetime limits (which Obamacare has mostly done away with). “The experience is not all negative,” Yarmuth said. And, he went on, “I’m confident that the national exchange will become as successful as the Kentucky exchange.”
For reasons I outlined a couple of days ago, I tend to agree with Yarmuth. Admittedly, the hearing didn’t shed much light on when the technical snafus that have plagued the federal Web site are likely to be resolved. Instead, it consisted largely of blame-shifting by the four technology contractors who appeared as witnesses, and political point-scoring by many, many representatives from both parties. One aspect of the corruption of Congress by lax campaign-finance laws is that committees that attract the attention of well-heeled interest groups—and which therefore generate large campaign contributions—have been greatly enlarged. The House Energy and Commerce Committee now has fifty-four members, and practically all of them were eager to appear on C-SPAN or one of the commercial news networks, which were covering the hearing intermittently.
When I tuned in, Congressman Joe Pitts, a white-haired Pennsylvania Republican who represents much of Amish country, was grilling Cheryl Campbell, a senior vice president at CGI Federal, one of the contractors that built healthcare.gov for the Department of Health and Human Services, about why it isn’t working. “If there was a silver bullet answer to that question, I’d give it to you,” said Campbell, a striking woman who radiated poise and competence. “It is a combination of a number of things.”
Pitts, an Air Force veteran who served in Vietnam and also helped fly B-52s loaded with nuclear bombs, didn’t seem very impressed with this answer. He asked why nobody had warned H.H.S., or members of Congress, that there were likely to be problems with the Web site. Campbell insisted that the part of the marketplace that CGI designed did work, and then she retreated into techno-babble, saying, “We were not part of the end-to-end visibility throughout the system.”
It went on like that. In her prepared testimony, Campbell put part of the blame on another contractor, Optum/QSSI, which designed the bit of the Web site that allows users to create secure accounts, and which quickly clogged up on October 1st. She also pinned responsibility on the Centers for Medicare and Medicaid Services (C.M.S.), the arm of H.H.S. that hired the contractors, noting that it “serves the important role of systems integrator or ‘quarterback’ on this project and is the ultimate responsible party for the end-to-end performance of the overall Federal Exchange.”
Slouched next to Campbell was a distressed-looking man with a receding hairline called Andrew Slavitt, who had the unfortunate task of representing Optum/QSSI. Under questioning from Representative Gene Green, a Texas Republican, he admitted the obvious: “The registration system was overwhelmed.” But Slavitt, too, had an out for his employer, or so he claimed. In the run-up to the launch, he said in his prepared testimony, C.M.S. had changed the specs of the Web site, insisting that all users register on the site before they could surf it for information about insurance options in their area. “This may have driven higher simultaneous usage of the registration system that wouldn’t have occurred if consumers could ‘window shop’ anonymously,” Slavitt noted.
At this point, the handle of the dagger used in the crime was pointing clearly at the anonymous bureaucrats in H.H.S. You might have thought this would be enough for the government-bashers in the Republican Party, but it wasn’t. Some of them are desperate to pin the blame directly on President Obama. And why not? He might be a former law lecturer who wouldn’t know an Oracle database from a floppy disk, but his name is attached to this damn thing.
Darrell Issa, the California wing nut and conspiracy theorist, has suggested that the White House, worried about possible “sticker shock” on the part of Americans when they saw the details of the new insurance plans, intervened and ordered the Web site to be altered to prevent random surfing. Evidently, Issa came up with this theory after meeting with some people from CGI. But when he asked Campbell, from CGI, about it, she was dismissive. Some of her colleagues’ statements to Issa may have been taken out of context, she suggested: “To my knowledge, no, the White House did not give us any instructions.” Later in the hearing, she said that the government person who gave the order was a “Mr. Chao”—evidently Henry Chao, the deputy director of C.M.S.
The Republicans’ next step may well be to call Chao before them and ask if anybody at the White House leaned on him to make the change. Even if this didn’t happen, and it seems unlikely, the Republicans will probably insist on hearing it from Chao directly. And as long as the Web site isn’t working properly this whole affair will continue to fester. More hearings are in the offing—Issa’s Committee on Oversight and Government Reform is keen to get in on the hunt—and the next big event will be the appearance of Kathleen Sebelius, the secretary of Health and Human Services. “We need to put together a timeline—figure out who knew what and when did they know it,” Representative Phil Gingrey, a Georgia Republican who apparently sees himself as something of a detective, insisted as lunch rolled around.
Of course, what we really need to do is get the Web site fixed A.S.A.P. The contractors insisted that their firms were working hard on the necessary changes, and that big improvements had already been made. But when will the site be operating properly? All the regal Campbell had to offer was this: “As soon as possible.”
Above: Cheryl Campbell, senior vice president at the healthcare.gov contractor CGI Federal. Photograph by Alex Wong/Getty.
