When polls show that most Americans still dislike Obamacare, they often obscure a key reason it lacks majority support: About a third of those who disapprove of the measure say it isn’t “liberal” enough, according to a May CNN survey. Everyone who feels that way – and even those of us who support the law despite its limits – has more reason today, with the news that the cap on annual out-of-pocket medical costs will be delayed a year, until 2015, to give the insurance industry more time to comply.
This follows last month's decision by the administration to delay the mandate that employers with more than 50 workers provide insurance.
To listen to some conservatives howl, you’d think the half-white Muslim Kenyan usurper had just taken another step toward nationalizing the insurance industry, when both these changes represent quite the opposite: a White House bending over backward to work with employers and insurers to smooth the transition to the new rules. Sen. Rand Paul told Fox News that the president is violating the Constitution by changing the implementation schedule. "The president doesn't get to write legislation, and it's illegal and unconstitutional for him to try and change legislation by himself," he said.
Imagine the outrage if Czarina Kathleen Sebelius had instead demanded that private businesses meet the deadlines despite their complaints. “We had to balance the interests of consumers with the concerns of health plan sponsors and carriers, which told us that their computer systems were not set up to aggregate all of a person’s out-of-pocket costs,” an administration official told the New York Times. “They asked for more time to comply."
House Speaker John Boehner is playing the faux-populist, accusing the president of “protecting big businesses from its health care law” and asking “when will the president give the same relief to everyone else?” Of course Boehner’s party has done everything it could to sabotage the law and prevent it from reining in the power of the insurance industry. He looks silly posing as Ralph Nader.
Experts debate how large an impact these two delays will have on consumers – the employer mandate is negligible, because more than 90 percent of large employers already provide coverage. But the optics of the delay aren’t good for Democrats. And they remind us what a jerry-built compromise this bill was, and how much of the inefficient and borderline corrupt insurance industry it basically left alone.
I’m not here to relitigate the 2010 battles over the inclusion of a public option in the Affordable Care Act. It never had the 60 votes it needed in the Senate, and according to Senate Majority Leader Harry Reid, former Sen. Joe Lieberman was probably more influential than any Republican in making sure it didn’t land in the legislation. But just last week Reid told a Nevada PBS show that he hopes Obamacare is a first step toward a single-payer system, saying he thinks we need to “work our way past” insurance-based healthcare. Pressed as to whether that meant the country should move to a Medicare-like single-payer system, he said, “Yes, yes. Absolutely, yes.”
I was happy to hear Reid at least talk about moving toward single payer, though we’re a long way from being able to do it.
The paradox of Obamacare is that its success depends in large measure on people who are determined to sabotage and subvert it. From the Republican governors rejecting its Medicaid expansion to businesses dragging their heels at compliance to the House GOP voting 40 times to repeal it rather than work with Democrats on ways to improve it, that the law exists at all is a small miracle. Of course a law that massive ought to have had lots of legislative fixes; big programs always have, in the past. But since the modern GOP rejects being a governing party, preferring obstruction and nullification, there’s no way to pass even fixes widely seen as necessary. Would Rand Paul sponsor legislation to delay the annual out-of-pocket cost cap for a year? Would he even vote for it?
Once again liberals are stuck defending a law that falls sadly short of what we believe is the right solution – in this case, a version of Medicare for all. Watching conservatives howl about Obama being too kind to big business, when they’d remove all of the law’s regulations entirely, is too much, and it's sad much of the media let them get away with it.