"It's not exactly a secret that the first month of the Affordable Care Act's open-enrollment period has been marred by dramatic difficulties. And whether one loves or hates 'Obamacare,' the administration deserves much of the criticism it's received...
...But when it comes to assigning blame and responsibility, President Obama and his team aren't the only ones on the hot seat.
Late last week, Todd Purdum had a surprisingly hard-hitting piece in Politico, making the case that 'calculated sabotage by Republicans at every step' is a 'less acknowledged cause' of the rollout's troubles...there is strong factual basis for such a charge."
I have written several blog posts on the way Republicans have done everything possible to thwart the ACA--from continued votes to repeal, to holding up funding, to refusing to set up insurance exchanges in Republican dominated states."(On Sunday, the) Washington Post (published a piece) on what went wrong with the system rollout...It noted a detail that's been largely overlooked: control over the online marketplaces had to be moved under the Centers for Medicare and Medicaid Services."
The article explained how the White House had expected most states to set up their own exchanges and provided plenty of money for that purpose. When so many Republican led states refused, there was not enough money to develop a federal exchange as extensive as was needed to deal with all the recalcitrant states and Republicans blocked any additional funding.
From the Washington Post Article:
"(Health and Human Services Secretary Kathleen) Sebelius simply could not scrounge together enough money to keep a group of people developing the exchanges working directly under her.
Bureaucratic as this move may sound, it was fateful, according to current and former administration officials. It meant that the work of designing the federal health exchange...became fragmented. Technical staff, for instance, were separated from those assigned to write...policies and regulations."
How exactly was this supposed to work in any efficient manner?"A White House official added, 'You're basically trying to build a complicated building in a war zone, because the Republicans are lobbing bombs at us.'...
...The scope of the GOP's sabotage campaign is hard to overstate. It includes everything from lawmakers ignoring constituent questions to public misinformation campaigns, discouraging public-private partnerships to denying implementation funds, blocking Medicaid expansion to blocking (Centers for Medicaid and Medicare Services) nominees in the Senate, refusing to create marketplaces to prohibiting 'Navigators' from doing their jobs.
Does a dysfunctional website matter? Of course it does, but so does this."
In the end, you have to compare the trouble people are having getting information or signing up for insurance in states that refused to set up their own exchange with the success of the ACA rollout in states like California and Kentucky where state-run exchange success stories are the norm.
This morning's New York Times highlighted the successful results in Kentucky in particular:
"(Kentucky's rollout problems have) been relatively few...Kentucky officials said. The primary contractor, Deloitte, worked closely with the state agency that runs health programs, ensuring guidance and oversight...Kentucky is spending $11 million in federal money to promote its exchange, and it shows."
If only Republicans had allowed the same co-operative effort to take place in their states.
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