From the day Obamacare was passed, Obama knew that getting the website up and running would be the key to the success of the law, and likely his presidency. Yet for the next two years, he and his team were completely unprepared for the task of actually getting it done, leaving us with the mess we have today.An excellent new piece in the Washington Post spotlights exactly how the Obama Administration managed to bungle the signature achievement of its first term, painting a picture of management errors, bureaucratic incompetence, and woefully misguided political calculations that ultimately derailed the rollout of the website:
Soon, however, it became evident that the office — with more than 200 people — would not survive on its own. It lacked tools, such as the ability to award grants and outside contracts, that were vital to its mission, said Richard Foster, Medicare’s chief actuary for nearly two decades before he retired early this year. So the office, with a slightly new name, moved in early 2011 into the Centers for Medicare and Medicaid Services (CMS), a large agency spread among locations in the District, Bethesda and Baltimore.The move had a political rationale, as well. Tucked within a large bureaucracy, some administration officials believed, the new Center for Consumer Information and Insurance Oversight would be better insulated from the efforts of House Republicans, who were looking for ways to undermine the law. But the most basic reason was financial: Although the statute provided plenty of money to help states build their own insurance exchanges, it included no money for the development of a federal exchange — and Republicans would block any funding attempts. According to one former administration official, Sebelius simply could not scrounge together enough money to keep a group of people developing the exchanges working directly under her.Bureaucratic as this move may sound, it was fateful, according to current and former administration officials. It meant that the work of designing the federal health exchange — and of helping states that wanted to build their own — became fragmented. Technical staff, for instance, were separated from those assigned to write the necessary policies and regulations. The Medicaid center’s chief operating officer, a longtime career staffer named Michelle Snyder, nominally oversaw the various pieces, but, as one former administration official put it: “Implementing the exchange was one of 39 things she did. There wasn’t a person who said, ‘My job is the seamless implementation of the Affordable Care Act.’ ”
The piece is long and makes many points, but on the whole, it looks like the website was doomed by a massive failure of management. Obama clearly identified getting the website right as his top priority. But he was unable to track its troubled progress and unable to ensure that the job got done.This reinforces our long-held view that Obama would have been a far more effective president if he’d served a couple of terms as governor first. Wrestling with Illinois’ problems would not only have given him a much deeper insight into the limits of blue model governance; it would also have taught him how to manage a large bureaucracy so that he can get it to do what he wants. If this account is accurate, it seems that the absence of this kind of executive experience crippled the rollout of his most important initiative.The piece also colors the way we look at the Republican Party and its political tactics. The GOP takes a lot of flak from the press about opposition tactics that are supposedly counterproductive, but if this story is right, the GOP has actually got the Administration so frightened and discombobulated that its fear of the opposition infects and degrades its policy process. To quote just one example:
According to two former officials, CMS staff members struggled at “multiple meetings” during the spring of 2011 to persuade White House officials for permission to publish diagrams known as “concepts of operation,” which they believed were necessary to show states what a federal exchange would look like. The two officials said the White House was reluctant because the diagrams were complex, and they feared that the Republicans might reprise a tactic from the 1990s of then-Sen. Bob Dole (R-Kan.), who mockingly brandished intricate charts created by a task force led by first lady Hillary Clinton.
It’s also clear that short term political considerations drove decisions that ultimately made website failure more likely. We suspect that as the finger-pointing and blame games go on, a journalistic paradise will take shape in DC. Insiders will start a war of competitive leaks, each looking for discreditable information that will throw the blame for the debacle on someone else. Since this looks like a royal mess, there is lots of blame to go around and the net effect of all the leaks will be to make the administration as a whole look worse and worse.In many ways, this report reminds us of nothing more than the NYT exposé of Obama’s mismanagement of the Syria crisis. Here again we see a massive public policy meltdown on a major issue and the President’s fingerprints seem to be all over some of the most important decisions gone wrong.The White House has plenty of time left and has massive resources on which it can draw; if the President can square the circle in the Middle East and turn Obamacare around, the conventional wisdom about his leadership abilities could change quite quickly. But at some point in a second term the perception of a failing presidency can become decisive. As the clock winds down on any president, power tends to flow away from the White House; bureaucrats and legislators no longer have as much to hope or to fear from a lame duck. If the president is facing low poll numbers and a perception among insiders that he just isn’t very good at his job, then his power declines even faster, and with declining power there are fewer opportunities to reverse the tide of events.This White House needs to change the momentum, fast, or it may not be able to change things at all.[Obama photo courtesy of Getty Images]