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Key Obamacare author warns of 'train wreck,' shows Dems fear 2014 health care politics

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Politics,Beltway Confidential,Philip Klein,Politics Digest

Senate Finance Committee chairman Max Baucus, D-Mont., scolded Health and Human Services Secretary Kathleen Sebelius on Wednesday over the implementation of President Obama’s health care law. Complaining about confused individuals and small businesses in his state and warning of a coming “train wreck,” at times Baucus sounded more like a Tea Partier than one of the key authors of the legislation that would become known as Obamacare. But his posture during the Finance Committee hearing is also a telling sign that Democrats up for reelection in 2014 are increasingly worried that mangled implementation could put their jobs in jeopardy.

In 2009, five different health care proposals made their way through the relevant committees in the House and Senate. The Finance Committee bill that Baucus authored was the closest to the finished product that Obama signed. Go back and look at Baucus’s bill, and you’ll see most of the law’s key components  there – taxes on insurers, drug companies, medical device manufacturers and high value health care plans; exchanges; the Medicaid expansion; IPAB. Also significant is what wasn’t in the Baucus bill – a public option, which had been a central component of the other proposals circulating through Congress, but was ultimately abandoned.

Yet despite his intimate involvement with crafting the legislation, when Sebelius appeared before his committee to discuss the health care provisions in Obama’s latest budget, Baucus used it as an opportunity to rip into her and other administration officials for what he described as the bungled implementation efforts.

Under the timeline of the law, health care exchanges are supposed to be open for enrollment on Oct. 1 and ready to dole out benefits at the start of 2014. But Baucus expressed skepticism that exchanges would actually be open in every state, including Montana. He also spoke of the confusion about the law he encounters when he goes back home.

“The administration’s public information campaign on the benefits of the Affordable Care Act I think deserve a failing grade,” Baucus told Sebelius. “You need to fix it.”

He continued, “I am very concerned that not enough is being done so far. Very concerned. When I am home, small businesses have no idea what to do, what to expect. They don’t know what affordability rules are, they don’t know what penalties may apply, they just don’t know.”

Baucus said that a CPA told him that small business clients are “throwing their hands up” and the CPA doesn’t know what to tell them.

“I just see a huge train wreck coming down,” Baucus warned. “You and I have discussed this many times and I don’t see any results yet.”

The key context is that Baucus is up for reelection in Montana next year in a state that went for Mitt Romney by a more than 13 percent margin and Cook Political Report rates him as vulnerable. Though the race is still considered to lean in his direction, if the implementation of Obamacare goes as disastrously as many expect, it could put him at risk.

Because his fingerprints are all over the law, Baucus cannot really run away from it. So what’s happening now is that Baucus is laying the groundwork to blame any failures on implementation, rather than design. Though the “train wreck” comment drew the most headlines, more telling may have been his comment that, “If the administration implements it correctly, millions more Americans will gain access to health care as a result of the law.” In other words, the law itself is fine, but the bureaucrats are screwing it up.

Politically, the strategy is similar to the one many Republicans who voted for the Iraq War pursued when the public soured on the war. They’d defend their support for the war effort while finding a way to distance themselves from elements of President Bush’s strategy, such as troop levels. Ultimately, this didn’t shield many Republicans from the Democratic wave in 2006 and I imagine if Obamacare implementation fails, a Baucus-style pivot won’t save vulnerable Democrats.

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