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Obama Blew Up the Health Care System. How Should the GOP Plan to Fix It?

I’m back! From the first Morning Jolt of the week:

Obama Blew Up the Health-Care System. How Should the GOP Plan to Fix It?

Ah! Great to get away for a few days, but good to be back. Let’s see, did anything get fixed about Obamacare while I was away?

How about that much-touted higher enrollment in the states?

About 49,100 people have enrolled in Obamacare plans through 12 state-run insurance exchanges, according to a consulting company that’s providing a hint on the data congressional Republicans sought during hearings in the past two weeks.

Enrollment through Nov. 10 represents 3 percent of the 1.4 million people projected to sign up in those states by the end of 2014, Washington-based Avalere Health said in a statement today. The data don’t include California, the most populous U.S. state, Massachusetts or Oregon. It also doesn’t account for those enrolled through the federal website serving 36 states.

Well, I’m sure that figure will jump when you include Oregon! Online enrollment is all the way up to . . . … up to . . . er, well, zero.

In Oregon, officials defend their decision to not open for online enrollment, saying the website is producing inaccurate determinations on tax credits and other government assistance. The technical problems have prompted a massive push to enroll Oregonians by Dec. 15 using old-fashioned application forms. The small business portion of the Oregon exchange is also not functioning.

So far, the Oregon exchange has cost more than $140 million in federal grant money.

Okay, so we’re looking at 50,000, plus California and Massachusetts . . . and then those gobs and gobs of people who signed up through the federally run sites, right?

Roughly 40,000 Americans have signed up for private insurance through the flawed federal online insurance marketplace since it opened six weeks ago, according to two people with access to the figures.

36 states, six weeks, 40,000 sign-ups.

So they aimed for 7 million in a six-month window, and after a month, they’re probably a bit past 90,000. Suppose California and Massachusetts’ systems are working fantastic — best-case scenario, we’re talking 125,000? 150,000?

At least the web site’s finally working, right?

“A key part of the site will be down over the Veterans Day weekend, including Monday, CMS spokeswoman Julie Bataille told reporters on a conference call Friday.”

Well, at least they’ll make the end-of-November deadline.

Software engineers and tech analysts scrambling to fix are discovering new problems by the day, as early fixes take hold and users are able to navigate more deeply into the troubled online application process, administration officials said Thursday.

“We are seeing volume go further down the application. What that means is we are identifying new issues,” said Julie Bataille, communications director of the Center for Medicare and Medicaid Services, the agency overseeing the site improvement.

“As volume is exposed to the system, we are identifying new issues, adding them to the punch list and working through them,” she said.

Ahem. I said, they are going to make the end-of-November deadline, right?

The Obama administration’s broader cooperation with insurers is a tacit acknowledgment that the federal insurance exchange — fraught with software and hardware flaws that have frustrated many Americans trying to buy coverage — might not be working smoothly by the target date of Nov. 30, according to several health experts familiar with the administration’s thinking.

We on the Right are entitled to sing “We told you so” as loudly and frequently as we want; after all, we did indeed tell everyone so. But at some point, we’ve got to tackle what we do from here, and how the Republicans should aim to mitigate the pain of Obamacare. When the GOP offers an idea in these circumstances, some on the Right will inevitably ask, “Why are we helping save Obama from the mess he made?” But we’re not trying to save Obama. We’re trying to save the American people who are getting screwed over by this.

So here’s the first big decision, between Representative Fred Upton’s version of the “if you like your plan, you can keep it bill” and Senator Ron Johnson’s:

The House and Senate bills differ, with Upton’s legislation taking a broader swipe at the law. It would allow all plans that existed on the individual market on January 1, 2013, to stay in effect through 2014, but also would go a step further, giving everybody — not just those who had the plans previously — the opportunity to purchase them. The Johnson bill, by contrast, would merely allow individuals to keep, in perpetuity, plans they had at any point between the enactment of Obamacare and December 31, 2013.

The Senate proposal hews closely to President Obama’s oft-repeated promise that if you like your plan you can keep it. That’s intentional: According to Johnson, his version stands a greater chance of attracting the Democratic support necessary to pass it into law. “I like what the House is trying to do there; I was just trying to narrowly focus my bill on trying to keep that promise that President Obama made for as many Americans as possible and not go beyond that,” he tells me. “I’m trying to actually attract Democrats’ support and make sure that they have no excuse to say, ‘That doesn’t just honor that promise, that goes beyond that promise.’”

Upton should win over a chunk of the opposition in his chamber: “Though the vast majority of Democrats will likely side with leadership, a sizable contingent of vulnerable caucus members — mostly freshmen — are expected to side with Republicans in bids to win over their more moderate-minded constituents ahead of the 2014 elections.”

Allow me to offer a separate idea: At some point, should Republicans push for a constitutional amendment declaring the federal government cannot require anyone to purchase a service or good as a condition of citizenship? Sure, John Roberts’s majority in the Supreme Court ruled the individual mandate was just another tax, but it’s good to lay down the marker that we are not little cogs to be hammered into place within the progressives’ grand machine.

Just how big a disaster could Obamacare turn into? Note that in a BusinessWeek cover piece, Erza Klein reminded us that the National Health Service in Great Britain spent $10 billion on a system for electronic medical records that “couldn’t be salvaged.”


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