Millions of Americans try to enroll in health care benefits during the first days of a new government health care program. They rely on indispensable government website that had been “pitched as a high-tech way” to sort through available coverage options. They’re encountering countless glitches and technical errors: the website freezes, displays incorrect plan information and sends insurers erroneous reports.
Administration officials — clearly caught off guard by the surge of technical difficulties — respond to “tens of thousands of complaints” from angry beneficiaries and promise to “fix every problem as quickly possible.”
This sounds like the familiar story of the last few days of the Obama administration’s rollout of the exchanges. But, actually, those quotes, and that scenario, are taken from the Bush administration’s efforts to implement the Medicare prescription drug benefit in 2005 and 2006.
Not only was Bush’s rollout “anything but smooth,” but administration officials had “some trouble getting the [online] tool up and running” and had to delay its debut for weeks. What’s more, computer glitches caused low-income beneficiaries to go without needed medications and sent pharmacies the wrong drug information. Before it was all resolved, Dr. Mark McClellan, Bush’s head of the Center for Medicare & Medicaid Services (CMS), appeared at hearings before the House Committee On Energy And Commerce, laying out the flaws in the law’s implementation and detailing how the administration would address them.
As the House Energy and Commerce Committee holds its first hearing on the implementation of the the Affordable Care Act on Thursday, it’s worth noting that some of the very same Republicans who are lashing out against Obamacare, arguing that the botched rollout is proof that the government cannot implement effectively and should repeal the law entirely, gave the Bush administration a pass and urged Americans not to pre-judge such a complicated process. At least four of the Republicans still on the committee had argued that early implementation hurdles should not taint the entirety of reform:
REP. JOE BARTON (R-TX): “This is a huge undertaking and there are going to be glitches. My goal is the same as yours: Get rid of the glitches. The committee will work closely with yourself and Dr. Mark McClellan at CMS to get problems noticed and solved.” [Barton Statement via Archive.org, 2/15/2006]
REP. TIM MURPHY (R-PA): “Any time something is new, there is going to be some glitches. All of us, when our children were new, well, we knew as parents we didn’t exactly know everything we were doing and we had a foul-up or two, but we persevered and our children turned out well. No matter what one does in life, when it is something new in learning the ropes of it, it is going to take a little adjustment.” [Murphy Floor Speech via Congressional Record, 4/6/2006]
REP. MICHAEL BURGESS (R-TX): “We can’t undo the past, but certainly they can make the argument that we are having this hearing a month late and perhaps we are, but the reality is the prescription drug benefit is 40 years late and seniors who signed up for Medicare those first days back in 1965 when they were 65 years of age are now 106 years of age waiting for that prescription drug benefit, so I hope it doesn’t take us that long to get this right and I don’t believe that it will. And I do believe that fundamentally it is a good plan.” [“Medicare Part D: Implementation of the New Drug Benefit,” 3/1/2006]
REP. PHIL GINGREY (R-GA): “I delivered 5,200 babies, but this may be the best delivery that I have ever been a part of, Mr. Speaker, and that is delivering, as I say, on a promise made by former Congresses and other Presidents over the 45-year history of the Medicare program, which was introduced in 1965 with no prescription drug benefit. And what we have done here is add part D, the ‘D’ for ‘drug’ or, if you want, the ‘delivery’ that we have finally provided to our American seniors.” [Gingrey Floor Speech via Congressional Record, 4/6/06]
Ultimately, the Bush administration fixed the law’s technical glitches, but more than half of the beneficiaries who ended up signing up for insurance didn’t do so until after the first of the year. Significantly, they signed up for coverage despite the Bush administration’s well-publicized initial glitches in extending coverage to low-income beneficiaries. Whereas only 21 percent of seniors had a favorable impression of the law and 66 percent didn’t know what was in it in April of 2005, by November of 2006, “half of the seniors polled said the program was working well or that just minor changes were needed.”
Bridge Project provided research assistance for this post.