This just leaked from the White House: New memos indicate trouble with Obamacare's implementation began well before President Barack Obama's re-election, and although the warnings were "specific and dire," it doesn't seem like anyone paid attention. The biggest part of the trouble, it seems, started three years ago, when significant gaps between Obama and certain officials who were to actually carry out the legislation's broad goals became blindingly apparent. In a report from CBS, who obtained the memo, Obama had the "vision", but the execution was another matter entirely:
David Cutler [a Harvard University economics professor], who worked on the Obama 2008 campaign and was a valued outside health care consultant wrote this blunt memo to top White House economic adviser Larry Summers in May 2010: "I do not believe the relevant members of the administration understand the president's vision or have the capability to carry it out."
No one on the carrying-out side, for example, had experience in the areas that you'd need to start a government health program from the ground up: While a dream team for this sort of venture would have ideally involved a few successful start-up people (from, say, Silicon Valley), as well as expert programmers for websites that could handle more than six peoples' enrollments. But according to Cutler, the people on the team who had complex start-up experience? Zero. Cutler had also expressed concern in his memo that the technology end of things — i.e. the website — might not be able to live up to the expected standard.
The result? The debacle that is healthcare.gov. Reports indicate that Americans are finding it more comfortable to sign up via paper applications because they feel like they're "moving forward" — a strategy promoted by Obama to both consumers and insurance companies beginning Oct. 21. However, another set of internal memos obtained by ABC indicates that just because customers are offline doesn't mean they're immune to trouble. Why? Both enrollment procedures — online and off —use virtually the same sign-up system. “The same portal is used to determine eligibility no matter how the application is submitted (paper, online),” reads an Oct. 11 Center for Consumer Information and Insurance Oversight memo — 10 days before the President's push.
And, the memos indicate, the Obama administration knew this: Essentially, the paper push was a PR move. By having customers fill out the application and send it off, it at least made them feel like they were getting something done, rather than have to grapple with the flickering website themselves.
“The paper applications allow people to feel like they are moving forward in the process and provides another option; at the end of the day, we are all stuck in the same queue,” said the notes from an Oct. 11 emergency meeting, which were obtained by House investigators.
Cutler was also concerned that policy coordination would fail — and it did. Miscommunication between departments, as well as different branches interpreting the health care policy differently, led to complications and misalignments that had to be rectified after the policy took effect. Notably, the one where users who signed up at the end of the enrollment period would have been penalized for going without health coverage the first three months of the year.
The President will be embarking on more damage-control Monday, giving a speech to a host of his allies who are working hard to sign everyone up — including Enroll America, Families USA, Protect Your Care, Planned Parenthood Federation of America.