The Grand Unraveling

HERE’S THE good news, kind of: Unlike this state’s lieutenant governor, some of those responsible for carrying out Obamacare’s grand plans on the state level have had the grace to resign after messing up.

The director of Minnesota’s health insurance exchange has submitted his resignation after one snafu after another came to light.

Ditto, Maryland’s.

The director of Hawaii’s exchange, having apologized for its poor performance, quit her job.

In Oregon, the director of its insurance exchange decided it was time to take a leave of absence for medical reasons. That state’s insurance exchange doesn’t sound in good health, either.

Vermont is complaining about the contractor it hired to run that state’s exchange, and disputing $1.1 million in charges.

Even in Massachusetts, which used to have a good health-insurance program, that state claims the contractor in charge of its sign-up program (Massachusetts Health Connector) “has consistently underperformed,” obliging that state to revert to its old software and even paper applications. Which happens when Connectors don’t connect.

And so it goes. Spottily across the country.

So many once functioning state insurance programs seem to turn into junk on contact with Obamascam. It’s a kind of contagion. By now the ever bumbling Kathleen Sebelius, the administration’s secretary of Health and Human Services and general scapegoat, has had to allow 36 states-at last count-to stick with their old insurance plans even if they don’t conform to Obamacare’s all too detailed requirements for coverage.

After millions of policyholders found their insurance policies canceled because they didn’t meet Obamacare’s requirements, the administration canceled the cancellations-but only for a year. To quote one unhappy and unwilling consumer in North Carolina, “I was glad for the one-year reprieve, but I would still like a permanent fix because I don’t need abortion coverage, I don’t need maternity coverage. We as a family had made the choice, and we are two intelligent people who know better what’s good for our family than the government does.” It’s just not easy to herd Americans; we tend to rear up and kick rather than take orders from distant bureaucracies.

Meanwhile, here in Arkansas, the best-laid plans for state-run health insurance-like the Private Option-can go awry, as some far-sighted legislators warned when the Private Option was being hailed as some kind of great breakthrough.

Of the 250,000 Arkansans newly eligible for Medicaid because of its expansion, maybe a quarter, or only some 68,000 at last report, have been signed up. Many of them are food-stamp recipients who have simply been automatically assigned an insurance plan under the state-subsidized Private Option because they didn’t indicate a preference.

An already overburdened Medicaid program will have to deal with all these newly insured-without Obamacare’s having provided a single new physician to care for them. Obamacare will continue to treat physicians as bookkeeping entries in its grand scheme rather than as human resources that require intensive education and cultivation. And the burden on both the state’s doctors and its budget will increase as the federal share of Medicaid’s cost is cut over the years ahead.

Come the next session of the Legislature, which opens soon, the Private Option will deserve re-evaluation. Carefully. Because this patient doesn’t sound in great shape.