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Saturday, October 26, 2013

Democrats Should Indeed Own the Rocky Rollout But Republican Sabotage Shouldn't Get A Pass

The Republicans clearly smell blood in the water. They are howling for Health and Human Services Secretary Kathleen Sebelius to be fired for the rocky rollout of the website. Needless to say, there is nothing they would love more than to manage to render such an indispensable position vacant at just this fraught moment in the implementation of this vast, complex, transformative legislation. You can be sure that they would obstruct any replacement for the position in absolute lockstep. They don't think it would be helpful in any way to fire Sebelius. They simply want to wreak havoc and cause pain. This is all they have ever done where the Affordable Care Act is concerned, and lately it is all they have been able to manage more generally.

The clip above has been circulating ever more deliriously online today. In it, Secretary Sebelius mentions that Republican obstructionism and sabotage has made a substantial contribution to the problems is having right now. Of course, Republicans are doing unseemly dances in the aisles over this claim, screeching about her incompetence and buck-passing and so on. Their reaction is as ugly and disproportionate as her stated critique is, to say the least, understated and restrained.

As it happens, I would say that the Obama Administration has bent over backwards to assume full responsibility for the difficulties of the rollout, and I would say that even the more progressively partisan outlets of the "liberal media" (like one finds in certain blocks of MSNBC, in between the old straight white guys defending "the Middle" shows like Morning Joe and Chuck Toddler and the awful prison exploitation films) have not hesitated to demonstrate their "evenhandedness" by declaring the rollout a complete catastrophe and megaphoning endless variations of the question: Is Obamacare DOOMED?!?!

To be honest, I think that in their zeal to own the website's problems and testify to their seriousness the left has actually given Republicans more or less a complete pass when in my view they are indeed primary authors in the present distress. The Medicare expansion was always one of the key ways the Affordable Care Act brought us closer to universal healthcare coverage, but the Supreme Court enabled States to opt out of participation in this expansion and many of the states with the most substantial uncovered and under-served populations are controlled by Republicans who want the program to fail. In the absence of medicare expansion in these benighted Republican states, the marketplaces are taking on an increased load. The Administration expected each state to create their own tailor-made portals to the regulated marketplaces. In part this was an obvious accommodation of the state-centered conservative governmentality. In states like Kentucky (more conservative) and California (more progressive) that created their own exchanges as planned, few to none of the problems that are attracting so much attention otherwise are happening at all. But, of course, many of the same Republican controlled states opted to frustrate rather than facilitate access to the marketplaces for their citizens, and hence the website is taking on incomparably greater numbers of users than anyone anticipated.

Also, to those who roll their eyes at the incompetence of an Administration that had three years to create this website for its signature history-making accomplishment, it actually matters that many of the states which opted to stress the site by refusing to create their own did not indicate this in any definitive way until the very last possible moment, not three years ago but months ago. Just as people across the right and the left endlessly parrot the objectively non-true "pundit fact" that Obama had two years of control of the House and Senate to get anything he wanted passed when the truth is that in the face of absolute Republican obstructionism Obama had the relevant majorities for just the period of weeks between the late settlement and seating of Al Franken and the replacement of the deceased Edward Kennedy by the Republican Scotty Brown, so too I believe that the objectively non-true "pundit fact" of the Administration's wasted three year lead in to the unveiling of the site will be parroted to the cost of sense from here on out. I agree that the Obama administration might have circumvented some of the scope of its terrible rollout by trying to code for the worst, or by regionally segmenting under different contractors and then drawing from successes as Howard Dean has recently proposed. But the simple fact is that hindsight is twenty-twenty and I do not honestly think one can responsibly demand that policymakers always manage to anticipate in advance the precise form irrational Republican obstruction will take in the name of foresight or due diligence. The shape of Republican sabotage is articulated precisely by their sense of the weaknesses available to hand from moment to moment, their sabotage and obstruction adapts in real time to the best efforts of the responsible people who are trying to make this massive unwieldy program work for the nation's citizens.

Hell, I wanted Medicare for All or some other single payer alternative -- and many of the difficulties Republicans are screeching about arise from the inherent mess of providing public universality (actually, generality) via private competing profiteering means. At every single stage of this process, Republican obstruction and sabotage has yielded suboptimal compromises the weaknesses of which it has then exploited to undermine their best effects. When Secretary Sebelius speaks of the role of the "political atmosphere" created by Republicans as "not ideal" for the proper coding and testing and implementation of the website -- when this "atmosphere" includes states making it illegal for in person Navigators hired by the Administration to provide information and help for citizens in need trying to access the benefits of a program passed by both houses of Congress, validated by the Supreme Court of the United States, and then mandated by a general election that turned on the question of the validity and desirability of the program in question -- it is hard to imagine a more flabbergasting understatement of the case at hand. Yes, the atmosphere created by the Republicans is non-ideal. Indeed. Needless to say, the modesty of her complaint has been and will continue to be rewarded with the bestial howl of jackals setting upon wounded cub.

By the way, jackals, the ACA is here to stay. Howl all you want, Republicans, but policies are improving because of ACA regulations, more and more people are covered by ACA, the refusal of Republicans to accept the Medicare expansion will topple them from State governments as citizens demand what their neighbors have from the ACA, the success of medicare expansion and nonprofit co-op options in the ACA marketplaces as compared to the private insurers will create the conditions for further expansion, eventually medicare buy-in might provide the public option that leads to single payer, meanwhile the ACA's control of rising healthcare costs will eliminate budgetary bullshit arguments for austerity while affordable healthcare provided by the modest compromised ACA for people who work for a living will still provide a position of more security from which to resist elite incumbents in their unfair practices and unjust demands. Watch out, reactionaries, the blood in the water you smell may be your own.

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