Obamacare Sold Out America

The most thriving co-op is Maine Community Health, which has taken 80 percent of the new market from Anthem Blue Cross Blue Shield (a WellPoint subsidiary) despite comparable prices. Co-ops in Nebraska and Iowa secured more than half the market, while Kentucky's co-op grabbed 60 percent.

The latter proved a bitter irony for McConnell, who was instrumental in eliminating funding for 26 other states. Next year, the Kentucky co-op will expand into West Virginia, one of three moving into neighboring states.

"We don't need to own the whole market," says Julia Hutchins, CEO of Colorado Health Insurance Cooperative. "There's an opportunity to push the entire industry in a direction more focused on consumers, and we can do that even with a very small market share."

Senate Finance Committee Chairman Max Baucus drafted an insurance industry insider, Liz Fowler, to lay the groundwork for what would become Obamacare.
Elena Schneider/Medill News Service/Creative Commons
Senate Finance Committee Chairman Max Baucus drafted an insurance industry insider, Liz Fowler, to lay the groundwork for what would become Obamacare.
Although Affordable Care Act enemy House Speaker John Boehner repeatedly claims the U.S. has "the best health-care delivery system in the world," the World Health Organization puts us at number 36.
Gage Skidmore/Creative Commons
Although Affordable Care Act enemy House Speaker John Boehner repeatedly claims the U.S. has "the best health-care delivery system in the world," the World Health Organization puts us at number 36.

Of course, not every co-op has been successful. Minuteman Health in Massachusetts, Evergreen Health Co-op in Maryland, and Oregon's Health CO-OP were hamstrung by faulty websites. Others wound up on the wrong side of price, such as Arizona's Meritus Health Partners, which was dramatically undercut by private insurers.

Some, such as the Louisiana Health Cooperative, have already run into trouble. Former CEO Terry Shilling tried to turn it into a money grab for his former health consulting firm, Beam Partners, proposing a four-year contract whereby Beam would receive a $3.3 million consulting fee, a 20 percent performance fee, and up to 50 cents for every person who signed up for the plan.

Moreover, there remains the question of what happens when some of the co-ops inevitably fail. Republicans, who have attempted to subvert Obama­care at every turn, are sure to turn such failures into Benghazi-sized incidents on Fox News. Those on the front lines don't possess much faith that Obama will have their backs.

"How do you spin that?" Hickey asks. "It is spin, and I'm not trying to be critical, but up until now, the administration hasn't done a great job of spin on any issue with the Affordable Care Act. So that worries me."


There's little doubt that Obamacare has achieved some remarkable things. Given that Congress can barely agree on whether to pay its bills, the simple act of helping 7 million people get insurance is extraordinary in itself.

And there is reason for optimism.

Brookings Institution scholar Thomas Mann is an expert in political dysfunction. He cowrote It's Even Worse Than It Looks: How the American Constitutional System Collided With the New Politics of Extremism. Considering the "Republican Party's swing to the right and decision to oppose anything," he believes it's important to take a long view of Obamacare.

"He succeeded where presidents for a half-century have failed, so it wasn't going to be pretty," Mann says. "And it wasn't going to be easy."

Every expansion of the social safety net has been contentious. None kicked off without difficulties. The question is whether Democrats will be willing to wade back into the fight to address Obamacare's woes — particularly the lack of cost controls and competition — while taking endless fire from Republicans, who've shown no interest in repairing health care.

As Mann sees it, Obama­care is but the first battle.

"Sometimes it takes something that looks God-awful to set things in motion for some steps that will eventually give us a better system," he says. "To the right, it looks like communism, but to more rational observers, these are constrained, incremental changes. But they could add up to something quite nonincremental."

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