The Symptoms of Failure: Diagnosing Bad Policy

Doctors have a hard job. They are expected to observe a diverse collection of physical symptoms, and, using their knowledge of medicine, correctly diagnose the patient.

Government policies are a lot like the human body: they can be sound, or, far more often, they can be sick. And just like doctors, we can diagnose this sickness by examining the external features of the policy in order to deduce a conclusion.

Few policies these days are so obviously under the weather as President Obama’s signature legislative achievement, the Patient Protection and Affordable Care Act. As we enter the second year of ACA enrollments, we, as responsible diagnosticians, have taken the time to outline some of the symptoms of a broken policy, and the ways in which they apply to ObamaCare.

Lowering Expectations

“Aim low. Aim so low, no one will even care if you succeed”

    -Marge Simpson

It is always a bad sign when your most touted achievement fails to live up to the hype, yet this has been a systematic feature of the ACA.

The latest example is the Department of Health and Human Services issuing a revised estimate of 2015 ObamaCare enrollments. The Congressional Budget Office originally projected the total number of people enrolled through the exchanges to be 13 million by the end of 2015. That number has now been revised down 30 percent to just 9 million. Considering there are already 7 million people signed up, we are looking at a very modest increase.

Additionally, HHS is projecting that about one in four new signups will have already had insurance. The move to the ObamaCare exchanges is a product of what the administration promised would never happen: cancellations. This that the 2 million increase projected is really only providing insurance for 1.5 million people. Hardly the universal coverage that was the expressly stated goal of the law.

This is a classic case of underpromising so that, when the results are underwhelming, the administration can still tout its law as a success.

Moving the Goalposts

“Well, it’s been two long trips, but we’re finally almost there again.”

    -Homer Simpson

In logic, moving the goalposts is a sure sign that you’re losing the argument. It is no more promising when it comes to public policy. We have seen this tactic being used repeatedly with the Affordable Care Act. Having failed to achieve an initial goal, the administration has made a habit of redefining success to meet their needs.

Last year, when it became clear that the projection of 7 million ObamaCare enrollees was overly optimistic, the Congressional Budget Office revised its prediction down to the more achievable number of 6 million. Then, when enrollment hit 6 million, they were able to tout it as a success, despite being well below their initial projection. This proved to be so transparent and unconvincing that the president unilaterally extended the deadline for enrollments in order to get an additional million signups.

Another example of moving the goalposts involves the projected date at which enrollments will level off. HHS is also now saying that it will take longer than the previously projected 2017 to reach a steady state of 25 million enrollees.

Unilateral Changes

“I hate the public so much! If only they’d elect me. I’d make ‘em pay!”

    -Homer Simpson

The Constitution vests Congress with the power to make or amend laws, and this is what separates the legislative branch from the executive. But when a law is as badly broken as the Affordable Care Act, don’t expect a little thing like that to stand in the way of the president and his appointed bureaucrats from circumventing Congress and making revisions on the fly.

Tyler Hartsfield and Grace-Marie Turner at the Galen Institute have catalogued a staggering 42 changes made to the Affordable Care Act so far, more than half of which came directly from the executive branch. If enrollments continue to underperform, we can certainly expect more down the road.

Among these changes are delays in implementations, numerous and varied deadline changes, authorizing special subsidies for Members of Congress, exemptions for labor unions, expanded waivers for private sector companies, and increasing funds for the insurance company bailouts,

The fact that a multi-thousand page law needs to continually be revised through unilateral executive action shows, not only poor planning and lack of foresight, but a deeper recognition that the policy itself is greatly and fundamentally flawed.

Broken Promises

“It takes two to lie: one to lie and one to listen.”

-Homer Simpson

By now it’s well known that the “if you like your plan you can keep it” mantra repeated by President Obama and numerous Democratic lawmakers was utter nonsense, so much so that it earned the title “lie of the year” from non-partisan, Pulitzer Prize-winning fact checking organization Politifact. By the end of 2013, 4.7 million people lost their health insurance plans as a result of the ACA, with hundreds of thousands more cancellations expected to come this year.

But this is far from the only lie that went into the marketing of ObamaCare. In addition to the above statistics, survey data has found that most of the people signing up for the ObamaCare exchanges last year – about six in ten –  were previously insured, about a million people have dropped out of the exchanges in the last year, and only 83 percent of people are expected to renew their policies. Taking all of this together, it’s unclear whether the Democrats’ plan for “universal coverage” has actually increased the net number of insured in a meaningful way.

One of the consultants who helped design the law, Jonathan Gruber, recently admitted in a television interview that the details of the law were intentionally kept opaque, and was only able to pass due to the “stupidity of the American Voter.”

Other lies include the claim that health insurance premiums would fall – they haven’t – and that ObamaCare would create jobs – it hasn’t.

Thomas Jefferson once wrote, “It is error alone which needs the support of government. Truth can stand by itself.” A policy that actually furthered the interests of the American people would not need to be sold on a bed of lies; only a hopelessly broken quagmire like ObamaCare requires such deception.

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These four symptoms – and there are others – are more than sufficient to diagnose a complete policy failure. Unfortunately, there is no cure for ObamaCare. It cannot be fixed by minor tweaks and patches. It is a law doomed to continue falling apart in a slow, lingering death. As responsible and compassionate Americans, we should do the merciful thing and put it out of its misery.