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Administration Issues Threaten Obama's Cherished Health Reform

By Ricrado Alonso-Zaldivar

WASHINGTON -- President Barack Obama's health care law risks coming unglued because of his administration's bungles and his own inflated promises.

To avoid that fate, Obama needs breakthroughs on three fronts: the cancellations mess, technology troubles and a crisis in confidence among his own supporters.

Working in his favor are pent-up demands for the program's benefits and an unlikely collaborator in the insurance industry.

But even after Obama gets the enrollment website working, count on new controversies. On the horizon is the law's potential impact on job-based insurance. Its mandate that larger employers offer coverage will take effect in 2015.

For now, odds still favor the Affordable Care Act's survival. But after making it through the Supreme Court, a presidential election, numerous congressional repeal votes and a government shutdown, the law has yet to win broad acceptance.

"There's been nothing normal about this law from the start," said Larry Levitt, an insurance expert with the nonpartisan Kaiser Family Foundation. "There's been no period of smooth sailing."

Other government mandates have taken root in American culture after initial resistance. It may be a simplistic comparison, but most people automatically fasten their seat belts nowadays when they get in the car. Few question government-required safety features such as air bags, even if those add to vehicle costs.

Levitt says the ACA may yet have that kind of influence on how health insurance is viewed. "An expectation that everybody should have health insurance is now a topic of conversation in families," he says.

That conversation was interrupted by news that the HealthCare.gov website didn't work and that people with coverage were getting cancellation notices despite Obama's promise that you can keep your insurance.

Obama maneuvered this past week to extricate Democrats from the cancellations fallout.

The president offered a one-year extension to more than 4.2 million people whose current individual policies are being canceled by insurers to make way for more comprehensive coverage under the law. This move by the White House was intended to smooth a disruption for which his administration completely failed to plan.

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