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Why Words Matter: The Affordable Care Act
13 Nov 2013

Why Words Matter: The Affordable Care Act

To me, there are some great aspects of the ACA, starting with the prohibition on discriminating against people with pre-existing conditions.  As a long time patient advocate, I know how important this is to millions of people.

Indeed, I’ve thought for some time that the Obama Administration should have reached out to the patient advocacy community and that this community – the same group that fought for stem cell research – should have been the public voice for advocacy and messaging around the ACA.  But that didn’t happen and the White House has really blown the messaging around Obamacare.  In fact embracing the term Obamacare itself was indicative of how they got this wrong.

I recall back in 2010 riding in a car with a key member of the House Democrat leadership when he was on the phone with the White House explaining that if they did not get busy telling the public about all the benefits of the legislation it would cost them the House.  The Administration passed the bill but never adequately sold it or explained it. The Obama White House never came through and the result was that the Democrats lost control of the House that year.

Fast forward 3 years to September, 2013  House Republicans are threatening to shutdown the government on October 1, the same date that open enrollment starts on the new website. There is no doubt in my mind that the White House exerted pressure on HHS to meet the deadline, glitches and all.  It’s just how White Houses of any administration work with the agencies. You can practically hear the conversations between the White House and  the HHS staff  in  which the White House made the calculation that if they rolled out the website on schedule then whatever glitches that existed in the site would quickly be overlooked because the public and media would be focused on House Republicans and the shutdown.

And they were right, at least for a few weeks. The stories and ire of the public were aimed straight at the House Republicans.  Tea Party members had hijacked Congress and the Nation, not only shutting down the government but more importantly threatening not to raise the debt ceiling despite what all but a few would say would be catastrophic results for the country.  GOP numbers plummeted at one point in time to a record breaking, and deserved, approval rating of only 8%.

But while more rational heads prevailed for the Republicans in Congress the Administration was not so lucky.  The website has been a debacle, indeed, according to CBS only 6 PEOPLE were able to sign up on day one! I don’t think the President or the White House staff had any real idea of how messed up the website was.

And it’s hurting him.  The Wall Street Journal reported last week that the President’s numbers were some of the lowest of his Presidency.  Democrats in Washington are broadly concerned that in yet another election cycle the ACA will be a real liability. In the Virginia Governor’s race Terry McAuliffe barely won his race against Cuccinelli as Cuccinelli  had run the last two weeks of the campaign almost exclusively on how terrible Obamacare would be for Virginians.  Prior to the roll out McAuliffe had been leading in the polls by double digits.

Perhaps the biggest blunder is the President himself who declared “ if people want to keep their health insurance, they’ll be able to.”  Turns out, this is not necessarily the case.  The Administration should have either laid the ground-work for what appears to be a rational change in the stated policy or they should have fought to change it.  They did neither, which is resulting in a serious drop in Obama’s poll numbers and helping the GOP capture lost political ground.   The fact that the people who are being dropped may have bad or weak policies is irrelevant.  The President didn’t set the table. Had he done so, this wouldn’t be an issue.  But he didn’t, and has subsequently undermined his leadership.   It’s his own version of “Mission Accomplished.” “Read my lips, no new taxes,” or “I did not have sex with that woman.”

To me the more alarming outcome of this mess is its effect on the American people.  Right or wrong, people will look at this as another example of a political leader not being straight with them.   Trust is the most important commodity of a leader and the President shot himself in the foot on this one.

What I would advise him to do is simple:

1)   Apologize clearly and sincerely, again and again until it sticks.  There’s currently ambiguity around his apology.

2)   Offer a specific fix for those who want to keep their insurance.  Make sure that everyone in the Administration knows what the talking points are and stick to them.

3)   Extend the timeline to sign up for insurance past the March 1 deadline and acknowledge that the computer site put the administration back.

4)   As they are trying to do, FIX THE WEBSITE

Regardless of your position on the ACA , one can’t help but acknowledge that the White House blew this roll out.  To me they snatched defeat from the jaws of victory.  Hopefully they’ll get it right – if not it’ll continue to cost Democrats at the ballot box.


The views in this blog post represent the viewpoints of individual team members, not Capstone National Partners as a whole.

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