What on Earth is Going on with Bill Clinton?

by George_East on November 14, 2013

Bill ClintonJust like John Major’s curious interventions over the last couple of weeks, the Big Dog has decided to get involved in the issue of health care in the US.   To say his intervention is not helpful to Barack Obama would be to put to mildly.    I’ll come back to that intervention in a bit, but first a little bit of context in case you’ve not been following this story particularly closely.

Obamacare has been having a very rough ride since the end of the government shut down – the story has moved from Republican attempts at blackmail during the shutdown, to the undoubtedly botched implementation of the Obama administration’s flag ship policy.  As ever the IT systems were simply not robust enough or ready for the applications to register for the new insurance exchanges (at the heart of the Obamacare system) and which opened for registration on 1 October of this year.  The administration had predicted 500,000 sign-ups in the first month, the actual figure through federal exchanges has been a pitiful, 27,000.   This overall picture is not quite this bad, as there are a further 79,000 registrations through state run exchanges.    But, on any view, these numbers make pretty grim reading.   What isn’t clear is how much of this under-registration is down to IT cock ups (which presumably can be resolved over time, at least if people can be persuaded that it can be made to work) and how much simply reflects lower numbers seeking to enrol.   There have been more than 800,000 applications, but the vast majority have not chosen an insurance plan.

The problems and the round the clock reporting of the problems have blown a huge hole in Barack Obama’s popularity ratings.  His approval numbers now look even worse than George W Bush’s at the same point in his presidency and way way below those of Bill Clinton and Ronald Reagan’s second term numbers.

The added difficulty has been that it is not only stories about IT glitches but also stories about existing insurance policies being cancelled.    This is leaving people who had (usually pretty shitty) insurance cover, with no cover while they try to navigate their way through the application and registration process.    The cancellations of some policies  is a feature of the system as the exchanges always required a broad risk pool (rather than just older or more sickly people) to be viable.   However, the transfer across to the new exchanges was supposed to be seamless.  The usual lesson not being learnt:  Big IT never works.  Further it has sent out the message to the notoriously government-sceptic American public, that the government is taking away your health cover.

Back to the Big Dog.  Bill Clinton’s intervention on Tuesday called for the Obama administration to honour its promise that ‘no one would be forced to change their insurance cover’.    This pledge was always somewhat foolish, as there would always be a small number of people who would be required to do so, if the Obamacare exchanges were to be viable.    So you might say, well if this was the administration’s promise then there can be no issue surely with Clinton reminding it of that fact.

This is where the problem comes in.  What Bill Clinton has done is to validate Democrats facing difficult re-election battles next year into opening up the whole debate around healthcare policy again.  Democratic Senator Mary Landrieu (of Louisiana) has a bill  already before the senate which would guarantee that people would not be forced to move from their existing policies, the consequence of which would be to make the risk pools under the Obamacare exchanges far less viable and the policies to be offered far more expensive.   It also, of course, allows all of the debates around repeal and congressional horse trading to gut Obamacare of any real effect to start again, and worst of all even opens up the real prospect of such an amending bill being front and centre in the campaign for Congress next year.

Bill Clinton is one of the most politically savvy poltiicans there has ever been.  He plainly has one eye on potential Hillary bid for the Whitehouse and is seeking to both ensure that the political environment is not too hostile to a Democrat running for office in 2016, and at the same time is seeking to distance the Clinton brand from a policy which at the moment is extremely unpopular.

The reality is that things could still improve markedly for Obamacare if the IT is fixed shortly and uninsured Americans see the benefit and those with insurance know that they will be able to access it should they lose such insurance in the future.   Obamacare is, to some extent, the victim of its own complexity (which was a consequence of the refusal to press for a public option and to keep it entirely private).     However, there is only a limited time for the administration to get it right – otherwise there is a very real risk that the policy which survived constant assault by the Republicans in congress, the election in 2012 and a nakedly political attempt to overturn it through the federal Courts, will bunk by the President’s own party.

For those interested in more, there is a superb piece by Ezra Klein of the Washington Post here.

{ 2 comments… read them below or add one }

Aunty M November 20, 2013 at 9:10 pm

As far as I can tell, if Hillary would become president she too would instill
her own brand of healthcare. I don’t trust her any more than I trust
Pres, Obama.

Reply

Charlie_East_West November 20, 2013 at 11:16 pm

Aunty M – I don’t particularly trust any politician, but the republicans however, are a bankable source of untrustworthiness.

Reply

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