Will the Obama administration meet its deadline — which, for those of you keeping score, is midnight tonight — for making significant improvements in the HealthCare.gov website?
Well, how you answer that question depends on which newspaper you’re reading this morning. The Washington Post says yes (“HealthCare.gov will meet deadline for fixes, White House officials say”). The Wall Street Journal says no (“Health Site Is Improving, But Likely to Miss Saturday Deadline”). And the New York Times, wisely, hedges its bets (“Health Care Site Rushing to Make Fixes by Sunday”).
You could be forgiven for being confused. But if you go ahead and read the articles, you’ll find that they agree on the essentials. All three reports note that there have been substantial improvements in the site. It’s much faster and many more people are getting through and signing up for health insurance. But it’s still not fast enough, there are still too many errors, and there’s a real concern that the administration won’t achieve its objective of signing up seven million people by March.
The extent to which the website has succeeded in meeting its short-term goals is open to debate. But if I were an administration official, I’d be wary about trumpeting “victory” to Washington Post. Hubris has been this administration’s besetting sin, and given the fact the rollout of the website has already been such a fiasco, the last thing the White House needs is a “Mission Accomplished” moment.
It’s clear that will take some time for the HealthCare.gov website to become fully functioning. But regardless of the website’s serious, and continuing, problems, there is reason for optimism about the ACA. This past week, Paul Krugman wrote a couple of persuasive columns arguing that not only is the ACA proving eminently workable in the largest state in the union, California, it’s also been associated with a dramatic decrease in health care costs.
Another hopeful sign for the ACA comes in the form of new research on Medicare. As we all know, the deepest, darkest fear of conservatives is that people who receive health care under the ACA might actually like it. And this, in turn, might change their minds about the role of government in health care — and many other areas of the economy.
This week at the political science blog The Monkey Cage, political science professor Amy Lerman reports on her research about the effect that receiving Medicare has on recipients’ attitudes towards government-provided health care in general. What she’s interested in is what political scientists refer to as the “policy feedback” effect of social welfare programs. She notes that
policies, once created, generate constituencies who benefit from those policies and will therefore oppose efforts to reform or repeal them. This “policy feedback” is what Republicans want to avoid and Democrats want to cultivate.
Lerman wanted to know: does Medicare have a policy feedback effect? Specifically, are 65- and 66-year olds who recently started receiving Medicare more likely to support government health insurance (i.e., the ACA) than are 63- and 64-year olds who do not receive public insurance?
Since these two groups are virtually identical in all respects except age and insurance status, you wouldn’t expect their attitudes to differ. Yet here is what Lerman found:
[Snip] 65- and 66-year-olds who currently receive public insurance also become more supportive of the ACA. This is all the more remarkable given that older Americans have often been the most hostile to the president’s health-care reform package. In addition, the effects of personal experience with public insurance transcend the partisan boundaries that are so prominent in public opinion about the government’s role in health care. In fact, . . . [snip] . . .personal experience with Medicare has the strongest effect on support for the ACA among political independents.
Bill Kristol has been wretchedly wrong about most things. But there is one big thing he got right. In his famous health care memo in 1993, he wrote:
the long-term political effects of a successful Clinton health care bill will be even worse–much worse. It will relegitimize middle-class dependence for “security” on government spending and regulation. It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government.
Indeed. That is what this fight is all about — and why Republicans are doing everything they can to throw sand in the gears. But regardless of the short-term fate of the website, the long-term prospects of the ACA are looking pretty good.
