The botched ACA website is turning from a problem into a catastrophe, what should we do?

Well, I think I am going all in.

I’ll get to why in a moment, but first an analysis of the extent of the problem.

HHS totally screwed up the on-line entry point for the whole federal system, healthcare.gov. It is hard to understand why this happened and they are desperately trying to fix it. In the meanwhile only a paltry 106,000 consumers are even close to getting enrolled in any new private insurance. About half of this business is through state exchanges that seem to be operating a bit better than the federal system.

A fairly significant number of enrollees have ended up in the Medicaid system – 396,261 according to HHS.

A slow start, to say the least.

Given the political atmosphere surrounding the ACA it needed a robust beginning and it did not get one. We ACA supporters needed to be able to say “See, it works and folks are being helped.” Then the opponents would have been left without an option. The President could have fought back and things would have rolled along. However, none of this happened.

Now the opposition is in full tilt destructive mode and the support for the ACA is falling like a rock in the polls.

Even the Democrats are running for cover instead of charging ahead to defend their program. The President has begun backpedaling on important ACA provisions. Some Members of Congress are offering changes to the Act that will undermine its potential to drive down the price of premiums. There are efforts to roll back the provisions against substandard benefits and consumer protections.

The House is voting today (Friday) on a change that the President has vowed to veto. The Right is calling for a total repeal.

If we scrap the ACA and start over what will happen?

The option that the opponents offer is, in a word, nothing. While it often is uncertain what the opponents want, repeal of the ACA also would kick a whole lot of folks off of Medicaid. At the very least, ordinary consumers go back to being at the mercy of the insurance companies.

On the Left, those of us who are single payer plan supporters will be tempted to say “I told you so.” We can argue of course that the thing is such a complicated hash that it was bound to fail. Why not just roll everyone into Medicare and be done with it?

The problem is that we did not have the votes in the Congress four years ago and we do not have them now. In fact, the current debacle may make it harder to argue successfully that we should expand the role of government to cover everyone through a public system.

So what do we do?

Here’s where I say we go all in.

OK, big talk, but what do you really mean?

Well, the term “all in” is from Texas Holdem, a poker game. It is a risky bet that frequently pays off big time. It means we stop wringing out hands and get back on track toward implementation of the ACA. It means that we start telling the politicians to stop the attack and get on with the fix.

Let’s put the opposition back on its heels by being aggressive.

We will not just be bluffing — we have some strong cards to play and we have a couple of aces in our hand.

Start pointing out that the alternatives are far worse than are the problems with the implementation of the ACA. Here are some questions to ask:

  • Do you know that the pace of enrollment under the ACA actually is more rapid than was the pace of enrollment under Romney Care in Massachusetts?
  • Do you want to abandon small business credits and subsidies to help with premiums?
  • Do you really want to throw students off of their parent’s insurance plans?
  • How about returning to the world of preexisting conditions and benefit limits?
  • Did you like double digit price increases?
  • Do you want to throw all those newly enrolled Medicaid under the bus?
  • Do you really want to have nothing as an alternative?

It is time to go back to the essential question: Do you want the insurance companies to run your health care?

Back to the offense folks or we will be eaten by the corporations once again.

Complicated though the ACA might be, abandoning it would shut down the health reform debate for another decade. Let’s stop worrying and get back into the fight.