The Lesson of Obamacare: Sabotage Works


Amy Goldstein and Juliet Eilperin have a big piece in the Washington Post today about the disastrous implementation and rollout of Obamacare following the euphoria of its passage in 2010. Goldstein and Eilperin document plenty of bad decisions along the way, and lots of them reflect poorly on Team Obama. Still, I have to say that my big takeaway from the article was the same as Andrew Sprung’s: sabotage works.

The primary example of this comes early in the story, when the team responsible for building the marketplaces—and the website—was moved under the Centers for Medicare and Medicaid Services (CMS). Partly this was for operational reasons, but:

The move had a political rationale, as well. Tucked within a large bureaucracy, some administration officials believed, the new Center for Consumer Information and Insurance Oversight would be better insulated from the efforts of House Republicans, who were looking for ways to undermine the law. But the most basic reason was financial: Although the statute provided plenty of money to help states build their own insurance exchanges, it included no money for the development of a federal exchange — and Republicans would block any funding attempts. According to one former administration official, Sebelius simply could not scrounge together enough money to keep a group of people developing the exchanges working directly under her.

Now, one obvious question is why the law failed to finance the federal exchanges. That was pretty clearly a mistake. Still, under normal circumstances, even an opposition party would end up cutting a deal eventually to shore up the missing funding. Not this time, though. As one White House official told the Post, “You’re basically trying to build a complicated building in a war zone, because the Republicans are lobbing bombs at us.”

There are plenty of other examples of this, and Sprung outlines them in his post today. No federal program that I can remember faced quite the implacable hostility during its implementation that Obamacare has faced. This excuses neither the Obama administration’s poor decisions nor its timidity in the face of Republican attacks, but it certainly puts them in the proper perspective.

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