President Obama's health care law was designed with a number of components that were inextricably linked. Ideally, it was supposed to function like a precision watch, with each individual part doing its job to make the whole work properly. But a month into its first open enrollment period, deep design flaws have been exposed, threatening the viability of Obamacare.
Obama set out to expand insurance coverage to Americans with lower-incomes, as well as those shut out of the individual markets as a result of pre-existing conditions. Doing so required forcing individuals to purchase insurance so that enough young and healthy people could be lured into the system to offset the costs of covering older and sicker Americans with higher medical expenses.
Once the government requires individuals to purchase insurance, government has to define what constitutes insurance, make it easier to purchase and provide financial assistance to those who cannot afford it. This is how government intervention begets more government intervention.
But Obama's carefully planned scheme began to unravel shortly after midnight on Oct. 1, when healthcare.gov -- Obamacare's main portal for residents of 36 states to purchase insurance -- failed almost as soon as it went live. By the next morning, millions of Americans attempting to access the site were deluged with error messages preventing them from creating an account.
Internal documents unearthed by the House Oversight and Government Reform Committee showed that just six Americans were able to enroll in a health care plan through the website on its first day. An estimated 7 million are needed to join Obamacare by March 30, 2014, for the program to succeed in its launch phase.
Having a nonfunctioning website is generating multiple consequences for the program. Given how difficult it is to sign up for insurance, the only people likely to go through the arduous process are those with high medical costs, while younger and healthier Americans may turn away in frustration, undermining the insurance pools. At the same time, policies covering millions of Americans are being cancelled.
This is happening — despite Obama’s promise that people who liked their plans could keep them — because their private policies do not meet Obamacare's definition of acceptable insurance. So, while they are subject to the individual mandate forcing them to buy new government-approved insurance, they cannot access the website that was supposed to make it easier and cheaper do so.
This is a Catch-22 that could delay or kill the program unless the website is fixed quickly. Ezekiel Emanuel, a key architect of Obamacare and now vice provost at Penn, said on Fox News Sunday that the website must be in good working order by Nov. 30 for Americans to meet the March sign-up deadline.
To keep down prices while meeting Obamacare’s requirements, many insurers have stripped down their networks of doctors and hospitals. In other words, the delivery side of Obamacare is quietly crumbling, while attention is focused on the troubles of the website. That could augur even bigger trouble. As critics have noted, the deeper problems with Obamacare won't be evident until Americans are able to log on and see for themselves what they're getting and how much they have to pay for it.