Democratic Senator Sees An ObamaCare “Train Wreck”

Senator Max Baucus had some harsh words for the Administration’s implementation of the Affordable Care Act:

WASHINGTON (AP) — A senior Democratic senator who helped write President Barack Obama’s health care law stunned administration officials Wednesday, saying openly he thinks it’s headed for a “train wreck” because of bumbling implementation.

“I just see a huge train wreck coming down,” Senate Finance Committee Chairman Max Baucus, D-Mont., told Obama’s health care chief during a routine budget hearing that suddenly turned tense.

Baucus is the first top Democrat to publicly voice fears about the rollout of the new health care law, designed to bring coverage to some 30 million uninsured people through a mix of government programs and tax credits for private insurance. Polls show that Americans remain confused by the complex law, and even many uninsured people are skeptical they will be helped by benefits that start next year.

A six-term veteran, Baucus expects a tough re-election in 2014. He’s still trying to recover from approval ratings that nosedived amid displeasure with the health care law in his home state.

Normally low-key and supportive, Baucus challenged Health and Human Services Secretary Kathleen Sebelius at Wednesday’s hearing.

He said he’s “very concerned” that new health insurance marketplaces for consumers and small businesses will not open on time in every state, and that if they do, they might just flop because residents don’t have the information they need to make choices.

“The administration’s public information campaign on the benefits of the Affordable Care Act deserves a failing grade,” he told Sebelius. “You need to fix this.”

Responding to Baucus, Sebelius pointedly noted that Republicans in Congress last year blocked funding for carrying out the health care law, and she had to resort to raiding other legally available departmental funds.

The administration is asking for $1.5 billion in next year’s budget, and Republicans don’t seem willing to grant that, either.

At one point, as Sebelius tried to answer Baucus’ demand for facts and figures, the senator admonished: “You haven’t given me any data; you just give me concepts, frankly.”

The biggest difficulty the Administration faces, of course, is the fact that last year’s Supreme Court decision gave the state’s the right to opt-out of the PPACA’s Medicaid expansion, a right which many states have afforded themselves in an effort to keep their own budgets in line. Additionally, the law makes the implementation of health care exchanges by the states entirely voluntary (there really was not other viable option), thus requiring the Federal Government to set up exchanges for those states that have opted out. Already, the Administration has granted extensions to those states that have yet to submit a plan to set up extensions, and the deadline is once again fast approaching. From an administrative standpoint, the PPACA is beginning to look like a logistical nightmare that Congress, inevitably and perhaps before the 2016 elections, is going to have to revisit.

FILED UNDER: Congress, Health Care, Quick Takes, US Politics
Doug Mataconis
About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010. Before joining OTB, he wrote at Below The BeltwayThe Liberty Papers, and United Liberty Follow Doug on Twitter | Facebook

Comments

  1. Moosebreath says:

    “a right which many states have afforded themselves in an effort to keep their own budgets in line”

    Umm, no. Since the Federal government is paying for 100% of the costs for the first 3 years, that’s not the reason. Rather, it’s a way for many Republican governors to signal that they oppose Obamacare to stave off a potential challange on their right.

  2. wr says:

    Of course, Baucus is one of the main reasons for the “train wreck” if it happens. It was to win him over that the public option was thrown away.

  3. libcap says:

    … everybody’s a critic.

  4. David M says:

    An unexpectedly large number of “conservatives” decided they would rather have the federal government run the exchange for their state instead of running it themselves. It’s a nonsense argument, but you can’t write laws assuming the people implementing them are crazy.

    The Medicaid and exchange challenges are problems intentionally caused by the GOP in their effort to make Obama and the Democrats look bad.

  5. Jeremy R says:

    “The administration’s public information campaign on the benefits of the Affordable Care Act deserves a failing grade,” he told Sebelius. “You need to fix this.”

    Responding to Baucus, Sebelius pointedly noted that Republicans in Congress last year blocked funding for carrying out the health care law, and she had to resort to raiding other legally available departmental funds.

    The administration is asking for $1.5 billion in next year’s budget, and Republicans don’t seem willing to grant that, either.

    Medicare Part D had a massive advertising push to sell its benefits to seniors. I imagine the GOP will explain their blocking of the same of the ACA as stopping pro-Obama propaganda or something, but it will just be yet another example of them trying to sabotage and make dysfunctional as possible, what’s currently the law of the land.

  6. Carl Collicott says:

    The reason no one is required to participate in the Health Care Act, as stated in section 1555, is simply the Act amends Public Law, | [Public Law 410] 58 Stat. 682 Public Health Service Act (pertinent part reproduced below), an International Agreement for Foreigners, and government owned corporation employers.
    google; Title 5 U.S.C. chapter 89 group health care

    One Hundred Eleventh Congress
    of the
    United States of America
    AT THE SECOND SESSION
    Begun and held at the City of Washington on Tuesday,
    the fifth day of January, two thousand and ten
    An Act
    Entitled The Patient Protection and Affordable Care Act.
    Public Law 111-148 ( available on line)

    TITLE I—QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS
    Subtitle A—Immediate Improvements in Health Care Coverage for All Americans

    *Sec. 1001. Amendments to the Public Health Service Act.

    Sec. 1555. Freedom not to participate in Federal health insurance programs.

    SEC. 1555 ø42 U.S.C. 18115¿. FREEDOM NOT TO PARTICIPATE IN FEDERAL
    HEALTH INSURANCE PROGRAMS.
    No individual, company, business, nonprofit entity, or health
    insurance issuer offering group or individual health insurance coverage
    shall be required to participate in any Federal health insurance
    program created under this Act (or any amendments made
    by this Act), or in any Federal health insurance program expanded
    by this Act (or any such amendments), and there shall be no
    penalty or fine imposed upon any such issuer for choosing not
    to participate in such programs.

    Public Health Service Act

    July 1, 1944 [H.R. 4
    624] | [Public Law 410] 58 Stat. 682
    TITLE I—SHORT TITLE AND DEFINITIONS
    SHORT TITLE
    SEC. 1.
    Titles I to V, inclusive, of the Act may be cited as the “Public Health Service Act”.
    SEC. 605. (a) Section 7 of the Act of September 7, 1916, entitled “An Act to provide compensation for employees of the United States suffering injuries while in the performance of their duties, and for other purposes”, as amended (U.S.C., 1940 edition, title 5, sec. 757),

  7. edmondo says:

    well, I was notified the other day that my 35 hour a week job was going to be cut back to 28 hours by July 1st to ensure that my company wouldn’t be penalized for not offering a healthcare plan in 2014. Once that happens I will have to work two different part time jobs to not afford health insurance premiums

    I suppose stonetools thinks that will make me show up in November 2014 and vote a straight D ticket – LOL!

  8. Tyrell says:

    I have seen some book advertised on tv: “Obama care Survival Guide”. If we need a survival guide for Obama’s “health care” program, we are in big trouble. I would like to know just how many pages the plan takes up.
    “I see a bad moon rising, I see trouble on the way” CCR

  9. David M says:

    @edmondo:

    Were they offering health care previously?

  10. Jeremy R says:

    I have seen some book advertised on tv: “Obama care Survival Guide”. If we need a survival guide for Obama’s “health care” program, we are in big trouble. I would like to know just how many pages the plan takes up.

    I’ve only ever seen that ad run on Fox News. It’s some cynical RightWing publisher exploiting Fox’s aged & fearful demographic.

  11. Craig Davis says:

    @Jeremy R: I’ve heard the ad on several radio stations in IA and IL, most not owned by Fox. Maybe you need to get out a little more?

  12. Craig Davis says:

    @Craig Davis: And the act itself and the regulations written so far cover how many tens of thousands of pages? I’m not yet aged, but I am fearful of a monstrosity of that size and complexity giving power to low level bureaucrats all over the country. You should be worried, too.

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  14. Carl Collicott says:

    @Carl Collicott:

    History of the Public Health Service…. The entity that will administer the Affordable Care Act.
    ……..we should all feel better……
    Tuskegee syphilis experiment
    (full version on line)
    From Wikipedia, the free encyclopedia
    The Tuskegee syphilis experiment[1] (also known as the Tuskegee syphilis study or Public Health Service syphilis study) was an infamous clinical study conducted between 1932 and 1972 in Tuskegee, Alabama by the U.S. Public Health Service to study the natural progression of untreated syphilis in poor, rural black men who thought they were receiving free health care from the U.S. government

    By 1947, penicillin had become the standard treatment for syphilis. Choices available to the doctors involved in the study might have included treating all syphilitic subjects and closing the study, or splitting off a control group for testing with penicillin. Instead, the Tuskegee scientists continued the study without treating any participants and withholding penicillin and information about it from the patients. In addition, scientists prevented participants from accessing syphilis treatment programs available to others in the area.[4] The study continued, under numerous US Public Health Service supervisors, until 1972, when a leak to the press eventually resulted in its termination. The victims of the study included numerous men who died of syphilis, wives who contracted the disease, and children born with congenital syphilis.[5]
    In 1972 the Tuskegee Study was brought to public and national attention by a whistleblower, who gave information to the Washington Star and the New York Times. Heller of PHS still defended the ethics of the study, stating: “The men’s status did not warrant ethical debate. They were subjects, not patients; clinical material, not sick people.”[11]
    Medical ethics considerations were limited from the start and rapidly deteriorated. To ensure that the men would show up for the possibly dangerous, painful, diagnostic, and non-therapeutic spinal taps, the doctors sent the 400 patients a misleading letter titled “Last Chance for Special Free Treatment”. The study also required all participants to undergo an autopsy after death in order to receive funeral benefits. After penicillin was discovered as a cure, researchers continued to deny such treatment to many study participants. Many patients were lied to and given placebo treatments so researchers could observe the full, long term progression of the fatal disease.[12]
    After penicillin was found to be an effective treatment for syphilis, the study continued for another 25 years without treating those suffering from the disease.
    In 1968 William Carter Jenkins, an African-American statistician in the PHS, part of the Department of Health, Education, and Welfare (HEW), founded and edited The Drum, a newsletter devoted to ending racial discrimination in HEW. The cabinet-level department included the CDC. In The Drum, Jenkins called for an end to the Tuskegee Study. He did not succeed; it is not clear who read his work.[18]^ Bill Jenkins left the PHS in the mid-1970s for doctoral studies. In 1980, he joined the CDC Division of Sexually Transmitted Diseases, where he managed the Participants Health Benefits Program that ensured health services for survivors of the Tuskegee Study.
    • Document from Tuskegee Syphilis Study, requesting that after test subjects die, an autopsy be performed, and the results sent to the National Institutes of Health

    Non-consensual experiments in Guatemala
    Main article: Syphilis experiments in Guatemala
    In October 2010 it was revealed that in Guatemala, Public Health Service doctors went even further. It was reported that from 1946 to 1948, American doctors deliberately infected prisoners, soldiers, and patients in a mental hospital with syphilis and, in some cases, gonorrhea, with the cooperation of some Guatemalan health ministries and officials. A total of 696 men and women were exposed to syphilis without the informed consent of the subjects. When the subjects contracted the disease they were given antibiotics though it is unclear if all infected parties were cured.[15]