“Hey do you have that Obamacare?” Carrie Underwood asked Brad Paisley during a sketch that kicked off Wednesday night’s 47th annual Country Music Association Awards. “Oh, its great. I started signing up last Thursday and I’m almost done.” Their mocking recreation of the enrollment process for insurance coverage via the cornerstone provision of the Affordable Care Act, the online marketplaces, was met with thunderous applause.
After “twerking”, Underwood led Paisley through the signup process, assuring him that the website’s spinning and smoking was not unusual. “It does that,” she said. They then broke into song set to the tune of George Strait’s Amarillo by Morning. “Obamacare by morning; why is this taking so long. We’ll have cataracts and dementia. Oh, this is getting on my last nerves. Obamacare by morning, over six people served.”
Indeed, on the first day of the six month enrollment period, only six people successfully signed up for policies, according to figures included in notes from twice-a-day “war room” meetings convened at the Centers for Medicare and Medicaid Services, CMS, after the federal website’s glitch-plagued October 1 launch.
The sketch was hardly a strong indictment of the health care reform, especially when compared to the criticism that has been levied at President Barack Obama, the law itself, and Obamacare’s implementers — Department of Health and Human Services Secretary Kathleen Sebelius and CMS Administrator Marilyn Tavenner — during the past few week’s congressional hearings. But the fact that Obamacare was used as material to begin an awards show is an indication of how the public perceives the Affordable Care Act.
Simply put, Obamacare can be distilled into a website that causes computers to smoke and an enrollment process so tedious that only six individuals have been able to reach the end. Of course, the sketch was only meant as entertainment, not as a serious critique, meaning exaggeration was no problem. Yet, if the technical problems plaguing the federal health care website were not deterring Americans from signing up, there would have been no Obamacare parody at the CMAs. That congressional outrage over the botched launch of healthcare.gov has colored the public’s view of the reform law has pushed the president to hit the campaign trail.
Obama made a visit to Dallas, Texas earlier in the week to encourage the highly conservative and Obamacare-resistant state to “put politics aside and not deny people health care out of ideology or politics,” according to David M. Simas, adviser to the White House. The idea pushed from the Democratic side of the aisle is that lawmakers should put aside their differences to make the reform viable not only because it has already been passed and implemented but because the only real losers if the reform fails are the American people. Underlying that sentiment is the worry that political rhetoric disseminated by the party’s Republican counterparts will negatively and unbiasedly tarnish public opinion.
Already, surveys have shown that Americans are displeased with implementation. When asked to recall “what you have seen, read, or heard about” the rollout of the Affordable Care Act, a survey conducted by the George Washington Battleground showed that a slight majority of respondents — 42 percent — said the coverage had made them less likely to be favorable toward the health care reform. Similarly, the Kaiser Family Foundation’s October Health Tracking poll found that 48 percent of respondents believe the federal government has done a poor job implementing Obamacare.
Even more importantly, that same poll reported that nearly two-thirds of the public have not been directly impacted by the law, suggesting that their negative opinions about implementation have not come from a particular experience. No one disputes that the website’s technical glitches have been a problem of such magnitude that the enrollment of millions of uninsured or underinsured Americans, individuals whose enrollment is essential to the success of the reform, could be derailed.
That customers have been unable to navigate healthcare.gov, fill in their personal information, or purchase the plans offered on the online marketplaces — all issues that may cause enrollment numbers to miss congressional projections for 7 million signups in 2014. Between 5 million and 7 million individuals will need to enroll for health insurance coverage via the exchange for the system to work, meaning only with enrollments of that magnitude will the exchanges have risk pools broad enough to balance out the proportionally higher medical costs of the sicker and older individuals who will likely be among the first to sign up.
“What I worry about is that there’s such a crisis of confidence people won’t enroll, and the very people we need to enroll, particularly our young people, to make this whole system work, won’t happen,” Senator Barbara Mikulski, a Maryland Democrat, said during a Tuesday hearing before the Senate’s Health, Education, Labor, and Pensions Committee.
For opponents of the federal health care reform, the problems have been a particularly sticky point, but not the only problem. The “website is just the tip of the iceberg,” Republican Senator John Barrasso of Wyoming said on the Senate floor on Monday. “There is the sticker shock for increased costs. There’s increased out-of-pocket cost in terms of deductibles and co-pays, and many Americans are not going to be able to keep their doctor, even if they’d like to keep their doctor.”
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