Washington • President Barack Obama has sought to tie the abysmal rollout of the Affordable Care Act to that of the last big health care law — the Medicare prescription drug plan.
That drug benefit for seniors began with one big thud. Its website didn’t work and seniors were turned away when they went to the pharmacy to pick up their pills.
In one rather embarrassing moment, Mike Leavitt, the former Utah governor, who was then in charge of implementing the law, had a hard time helping his parents pick a plan that didn’t threaten their broader health coverage.
But once those early mistakes were corrected and seniors were able to sign up, the drug benefit gained popularity and now is seen as a big success.
Leavitt, who served as President George W. Bush’s Health and Human Services secretary, doesn’t shy away from the comparisons between the implementation of Medicare Part D and the law known as Obamacare; he embraces them. But he notes it is far from certain that this administration can pull off what the last one did.
In an interview with The Salt Lake Tribune, Leavitt says it all hinges on fixing the broken website, which has stymied people attempting to shop for insurance.
“If the system is working by early December and people can enroll, this will be an interesting chapter in somebody’s book,” said Leavitt, who now runs a consulting firm helping states and companies understand the new health law. “If the system continues to be dysfunctional, the problem will become a chapter in history.”
Promised fix • The White House promises that the website — healthcare.gov — will be fully functional by the end of November, capable of interacting with the variety of systems necessary to offer various plans and potential federal subsidies.
If that goal is met, people not covered through their job would have two weeks to shop if they want to be insured on Jan. 1. Anyone not covered by the end of March faces a tax penalty.
Because of the massive technology failure, some Democrats have started to side with Republicans, who want to delay the requirement to have insurance, known as the individual mandate. Asked about a potential delay, Leavitt said: “The jury is still out, but doing so has cascading implications.”
Leavitt expects the White House to block such efforts — with a veto if necessary — because it would be “admitting failure — showing weakness in the face of the 2014 midterm elections.”
He also said it would cause problems for insurance companies, hospitals and medical-device companies, among others, who were taxed to pay for the law with the promise that they would get millions of new customers.
Leavitt warns that other potential pitfalls remain. He wonders whether enough young, healthy people will sign up to make the program economically stable and whether the system has adequate security measures to protect sensitive personal data.
Obama and Democrats who support the law have tried to beat back the criticism of its failed Oct. 1 rollout by saying the Affordable Care Act is far more than a website. They have also criticized Republicans for vehemently fighting the law, instead of helping to make it as successful as possible.
Democrats and Republicans • In a speech in Massachusetts last week, Obama noted that Democrats weren’t big fans of Medicare Part D when it was implemented in 2006, but didn’t try to torpedo it.
“Democrats weren’t happy with a lot of the aspects of the law because, in part, it added hundreds of billions of dollars to the deficit, it wasn’t paid for — unlike the Affordable Care Act, which will actually help lower the deficit,” Obama said. “But, you know what, once it was the law, everybody pitched in to try to make it work.
Democrats weren’t about to punish millions of seniors just to try to make a point or settle a score. So Democrats worked with Republicans to make it work. And I’m proud of Democrats for having done that. It was the right thing to do. Because now, about 90 percent of seniors like what they have.“
Leavitt said Obama’s comment “makes me smile,” suggesting it is a rather generous portrayal of the Democrats’ reaction to Medicare Part D.
The former governor said Democrats didn’t criticize Part D because of its cost, but because they preferred an even larger, more-generous program. And while Democrats didn’t wage an all-out campaign to undermine that law, as the Republicans are doing with Obamacare, they did call for a one-year delay in its implementation.
Sen. Orrin Hatch, R-Utah, voted for Part D and against the Affordable Care Act, and he suggested the Democrats’ argument is as sound as “comparing a ripple in a pond to a tidal wave” because the drug program is for seniors only, while Obamacare impacts everyone.
“Utahns knew that with Medicare Part D, once we got through a few bumps in the beginning, the program would lower health care costs,” Hatch said. “Unfortunately, that can’t be said with Obamacare.”
As the top Republican on the Senate Finance Committee, Hatch will have a chance to question Kathleen Sebelius, the current Health and Human Services secretary, on Wednesday.
Sebelius appeared before a House committee last week and apologized for the problem, saying she was accountable.
She defended the law and deflected calls to postpone its rollout any further.
Leavitt joked that “Double Down,” the name of a tell-all book on the 2012 election, would also be a good name for the Obamacare implementation.
“They’re going to bank on fixing the exchanges and getting some good news over the next six months.”