Is Obamacare fated to be a “train wreck”? Matt Yglesias says no, but warns us of what to expect as it rolls out:
You have to remember a few basic facts about ACA implementation coverage over the next 18 months. One is that the media has a large negativity bias. The other is that the aspirations of the law are quite high, and the status quo is quite bad. That means any time the situation improves but doesn’t improve as much as the Obama administration wanted things to improve, that will tend to be covered as “bad news for Obamacare.” That tendency will be re-enforced because Republicans will be eager to trumpet Obamacare’s shortcomings (to make Obama look bad), and advocates for the poor will also be eager to trumpet Obamacare’s shortcomings (to build pressure for improvement). So you’ll hear lots of completely accurate stories about things not working quite as well as proponents had hoped. Just recall that this is always how things go.
Obamacare will suffer from what I call the “big country problem”: in a big country, even a tiny percentage is a big absolute number. This means that even something rare can be made to look common. Obamacare is a classic case: it’s a gigantic, bureaucratic program that affects tens of millions of people, and that means it will inevitably run into lots of problems. A 99 percent success rate, after all, would still mean hundreds of thousands of horror stories. This is going to give the Fox News set plenty of opportunities to insist that the sky is falling.
But it probably won’t be. Obamacare will have plenty of growing pains, and on a broader scale it will have unintended effects that genuinely need to be addressed. This will be harder to do than usual since Republicans are rooting for failure and will be generally unwilling to tweak the law to improve it. Hopefully this will change over time as constituent pressure mounts, but we’ll have to wait and see about that.
In the meantime, if you want to know where the “train wreck” metaphor came from in the first place, and how it’s been mangled beyond recognition over the past few months, Dave Weigel has you covered.