Obamacare's Saving Grace: The Middle Class Uses It Too
Generally speaking, one of the guiding principles of politics is that programs for the poor can be managed badly and nobody cares. But if a program for the middle class is badly managed, there's hell to pay. More broadly, there's ample evidence that politicians—even liberal ones—care about the middle class, but not about the poor. Not at all.
Today Ezra Klein talks to Peter Super, a professor of law at Georgetown University, who notes that the rollout of Obamacare's federal exchange was actually fairly typical for a new program that serves low-income people. "But the recovery has been startlingly fast."
EK: There’s an old line that goes, “programs for the poor are poor programs.” When you compare programs that are used by the poor, like food stamps, to programs used by Americans of all income brackets, like the IRS or the DMV, do you think the old adage holds true?
PS: It’s night and day. I hear people complain about the IRS and I’m just astounded. Its level of customer service is radically better than what we see in even fairly well-run poverty programs. There’s all sorts of things the IRS would never dream of doing that are absolutely routine in these other programs. They actually give people a chance to explain things.
....EK: So how do these programs get improved? With Obamacare, a lot of middle class, and even upper middle class, people were using the system, and because it was all online, it was easy for journalists to try it out, and so there was a lot of public pressure. But what do you do when services don't get as much attention and don't have beneficiaries with political power?
PS: Having people with political clout involved certainly makes a big difference. In 1995 or 1996, when the means-tested programs were being overhauled in Congress, the cuts to the school lunch program were far from the most severe being imposed. But because they hit middle-income kids, the outcry was enormous and they were dropped even as more severe cuts to things like food stamps went through.
But to the extent we can’t get to that, we need to see federal agencies adopting and enforcing best practices, in particular standards for proper testing before rollout, proper success in pilot programs before things go statewide, and proper human fallback to make sure that people aren’t cut off from the program if the automated systems fail.
This is similar to the outcry over the sequester cuts to the FAA. Unlike a lot of the cuts, that one caused delays at airports, which affected the middle class, the rich, and journalists. And guess what? It got rolled back pronto. But the cuts to food assistance and Head Start? Not so much.
The Obamacare website rollout might have been a fiasco, but its saving grace was that it was very public and had a big clientele among the middle class. So it got fixed. Pronto.