The sign-up period for 2014 individual insurance coverage required under President Obama's Affordable Care Act expires Monday, much as it began.
There were HealthCare.gov website snafus, White House pleas for enrollees, and the need for "navigators" to help those enrollees work their way through the often-balky federal insurance exchange site. (Which was temporarily out of service twice by midafternoon Monday.)
Now, though, the political bickering is focused on the administration's estimate that it will exceed its first-year goal of enrolling 6 million people in health care exchanges, and on whether the law has hit its target: the nation's uninsured.
"We know that there are going to be more people in this country, in the millions, who have insurance than would have had it before," White House spokesman Jay Carney said during his regular briefing with reporters Monday afternoon.
"It will be very hard for Republicans and other critics to make the argument that a better world would be a world in which all those millions of Americans didn't have health insurance," he said.
Critics, however, don't appear terribly hobbled by Carney's argument, and have ramped up a political assault on Obama's signature legislation that began when he signed the Affordable Care Act four years ago.
Sen. John Barrasso, R-Wyo., accused the president of "cooking the books" to beat enrollment projections. Others questioned how many previously uninsured people have gotten coverage through the new system, and how many have lost their old coverage.
Carney bit back Monday, suggesting that the administration "could have saved ourselves a lot of pain" by cooking the numbers a lot earlier — say, back in the disastrous early enrollment days in October and November.
While Washington bickering continued and dueling ACA failure and success stories took hold across the media, here's how the law played out in two swing states with Republican governors: Florida, where Rick Scott declined to establish a state-based exchange to help residents sign up for insurance; and Nevada, where Brian Sandoval and the Legislature built a state exchange.
Nevada
Nevada is one of a handful of states — a list that includes Maryland and Oregon — where state-level insurance exchanges have been dramatic failures due to technical and design problems.
The state initially projected it would enroll 118,000 people through Nevada Health Link; the most recent goal is 50,000.
"It's been a disaster here," says Jon Ralston, a longtime Nevada political columnist and commentator.
Fingers are being pointed in all directions, including at Xerox, which had a $75 million contract to erect the site, Ralston says. But laying political blame is tricky.
"This is giving fuel to those who want to criticize Sandoval, who made the decision to set up the state exchange," he says. The popular governor, however, "is bulletproof," he says. And, he notes, the exchange was supported by bipartisan majorities in the state Legislature.
An unlikely Nevada source, however, has given national Republicans a serving of anti-Obamacare fodder: the Unite Here labor union, which includes the powerful Culinary Workers Union Local 226, a key force in Obama's Nevada success in 2008 and 2012. It has emerged as one of the most strident opponents of the health care law, arguing that the law will benefit insurance companies at a steep cost to its members.
The union activism on the issue will likely have more political effect nationally, Ralston says, where Republicans are using it as proof that they aren't the only ones who don't like the law.
Florida
It's only March, and former Gov. Charlie Crist hasn't yet claimed the Democratic nomination to challenge GOP Gov. Rick Scott in the fall.
But Scott's campaign last week began running 30-second ads that feature Crist's outspoken support of the heath care legislation, quoting him as saying, "I think it's been great" for Florida.
Though the accuracy of some claims in Scott's ad — including one that asserts 300,000 residents have had their health care plans canceled — has been assailed by Crist's team, the governor is following the national Republican campaign playbook.
How the issue will play in a decidedly purple state, says political columnist Daniel Ruth of the Tampa Bay Times, is not clear.
"Scott is trying to hang this around Charlie Crist's neck, but a lot of the problem Florida is having with the implementation can be laid at the feet of Tallahassee itself," Ruth says. "This is a state that refused to expand Medicaid, and refused to set up an exchange."
"Crist is on record saying that Obamacare is great, and I expect he'll adopt the 'amend it, don't end it' posture," he says. "If you're a Democrat, you damn well better be on board with this."
That's the message that Democrat Alex Sink used in her recent special election loss to Republican David Jolly for the congressional seat long held by the late GOP Rep. Bill Young.
Ruth says he believes that Obamacare was just one issue in the Sink-Jolly battle, and perhaps not the defining one.
"If he had waxed her by 10 points instead of 2 points, maybe," he says.
Recent polls suggest that Floridians are divided largely along party lines on the health care law. Scott wants it repealed.
Nationally, with enrollment exceeding 6 million, Obamacare appears intact if wobbly. House Speaker John Boehner on Monday also embraced again the notion that Republicans in Washington are focused — politically, at least — on a repeal message. And a replace one, too.
"House Republicans will continue to work to repeal this law and protect families and small businesses from its harmful consequences, and that's why we're taking action this week to repeal the law's 30-hour rule that has become a significant barrier to job growth and higher wages," Boehner said in a statement. "We will also continue our work to replace this fundamentally flawed law with patient-centered solutions focused on lowering health care costs and protecting jobs."
Copyright 2021 NPR. To see more, visit https://www.npr.org. 9(MDIxMDkyNjUxMDE0NDY1Njg1NzRiOTRiYQ000))
