Before the October 1 rollout of Healthcare.gov, a key concern was whether the Affordable Care Act system would create a "death spiral" for insurers. That crisis could be precipitated by an unenthusiastic response from younger, healthier Americans. These are the people whose high premiums and low demand for services are necessary for the risk pools to assume the costs of covering pre-existing conditions at community-pricing rates, as well as buffering the premiums of older and needier Americans.
Instead, the emerging "death spiral" crisis is one of the credibility for the White House and the idea that big government-program interventions work better than the private sector those interventions seek to reform.
The Department of Health and Human Services had 42 months and $400 million to create an operational Web portal that connects Americans who now are required by law to buy coverage from insurers, while connecting to the IRS to qualify people for federal subsidies in the exchanges.
For the last several months, HHS and the White House assured everyone that the system development was on track for an October 1 launch. Democrats fought a pitched battle against Republicans over the last month to keep the GOP from forcing a delay of the rollout.
Now, suddenly, the idea of a delay has moved from the ramblings of "anarchists," as Harry Reid described Obamacare opponents, to mainstream Democratic thought. Sen. Richard Blumenthal, a Democrat from deep-blue Connecticut, told a panel on MSNBC on Thursday that the mandate needs to be delayed, depending on "how soon these glitches are going to be solved." That will depend, Blumenthal said, on "leveling with the American people."
That honesty has been in short supply. More than two weeks into the crisis, HHS Secretary Kathleen Sebelius told CNN's Sanjay Gupta that President Barack Obama had no inkling of the failure until he read about it in the papers, which follows a pattern of denials at the White House. Sebelius also implied that the failure took her by surprise too, even though the ACA was her agency's highest priority over the last 42 months, and the system failed a light-load test days before the launch.
Sebelius must have also missed the August report from the HHS Inspector General pointing out major flaws in the system and its testing, even though Reuters managed to notice it.
Even former White House press secretary Robert Gibbs called the notion that the White House didn't know about the Healthcare.gove problems "unbelievable," while National Journal's Ron Fournier called it "either a lie ... or an unfathomable lack of oversight." It could also be both, which is the possibility that now has Democrats doing a 180 and suggesting or demanding delays in the rollout.
Constituents fear dealing with IRS penalties for failure to buy insurance through a system they can't access and HHS can't fix, or even predict when it will be fixed. Even those who have managed to buy insurance through the site now have to wonder whether their insurers have their correct data. Meanwhile, Obama and Sebelius now want to reassure Americans that they have a grip on the problem ... by bringing in the private sector to fix what the government failed to execute.
Rarely have we seen such a confluence of incompetence, irresponsibility, and prevarication all at the same time. The death spiral of White House credibility won't just damage Democrats in the short run, but it will damage the agenda of advocates of activist government for years.