Employees of the drugstore chain Walgreens are just the latest to learn the hard way that presidents don't always have the power to make good on their own promises.
Walgreens recently announced its intention to switch away from offering company-provided health insurance to its employees. Instead, Walgreens employees will be given a set amount of money to choose a plan from a private marketplace. IBM and Time Warner plan to do the same for their U.S. retirees.
Walgreens, and the other large employers who have opted to change their insurance options, say they made the switch because of rising health care costs and higher expenses because of more regulation related to the Affordable Care Act. And as provisions kick in forcing insurers to be more generous in their coverage and prohibiting them from charging higher-risk customers a fair market rate, I expect costs to explode even faster.
Businesses trying to claw their way to profits in a struggling economy are looking for creative ways to save money. Kicking workers onto exchanges, where they'll have to shop around for a plan that meets their needs and pay for it out of pocket, is proving to be an appealing option. Other employers are switching workers to part time so they don't have to pay for insurance plans at all. (And if you think it's just greedy corporations who would stoop so low, recall that cash-strapped local governments are among those reducing worker hours.) Unfortunately, for the individuals in question, this means massive disruptions to their access to health care and financial situations.
Since well before the ACA's passage in 2010, Americans were expressing anxiety about how the reform would affect their ability to get medical care for themselves and their loved ones. Public opinion research shows people have long been worried they won't be able to afford the insurance plan they have and like or be able to see the doctors they know and trust. They fear – not irrationally, it turns out – that prices could shoot through the roof and that companies might cease to offer as many good alternatives under the new regulations.
These are legitimate concerns shared by millions of Americans. They're also concerns that have been routinely dismissed as trivial by the administration. Time and again, President Obama insisted individuals who already had coverage had nothing to worry about. "If you like your health care plan," he famously said, "you can keep your health care plan."
That was always a dubious assertion. Numerous economists, to say nothing of half the officeholders in the country and more than half the people, were skeptical that a new system could cover the uninsured without wreaking havoc on the already insured. Yet the Obama administration took great pains to assure voters their existing health insurance would not be affected.
Much of the law has yet to go into effect, but those claims are already ringing hollow. Take UPS, which has decided it will no longer offer coverage to spouses of its employees who can get insurance elsewhere. For those 15,000 men and women, the option to keep their plan if they like it is simply no longer available to them.
The uncharitable characterization is that the president was intentionally misleading the American people in order to corral support for his top political priority. But the more likely, and arguably more troubling, conclusion is this one: Obamacare's supporters, who professed with such conviction that Americans with insurance wouldn't be affected by the law, actually believed that to be true.
If, in fact, the law's authors thought that under their plan everyone would be able to keep their existing policies, that is immensely revealing. That people might alter their behavior in response to changing incentives and stimuli never seems to have occurred to them. That the law might have some negative side-effects – like encouraging young people to wait until they're already sick to sign up for coverage, since they now know they can't be turned away, or discouraging small businesses from hiring new people, since the cost of providing the mandated insurance will now be so much higher – struck them as laughably absurd. Surely people would recognize their moral obligation to behave within the expectations of their rulers!
But things haven't played out as Washington expected. And as a result, a law passed with every intention of making things better for suffering Americans will ultimately make things worse for almost everyone. When medical care gets more expensive, it's the poorest who are priced out of access. And when we're forced to spend more trying to provide that care to those who can't afford it, it crowds out our ability to put those extra dollars to use on other even more valuable pursuits.
So the American people are learning the hard lesson that politicians can't always do everything they say they will. But perhaps President Obama is also learning a lesson – that putting your name on massive pieces of sweeping federal legislation is not always as good an idea as it sounds. Because even the smartest, most well-intentioned people will find that trying to manage an economy as complex as ours is a fool's errand. And dictating top-down solutions on markets composed of hundreds of millions of autonomous actors often leads to unexpected, unintended and unwelcome outcomes.
Which is all another way of saying that governing is hard. The ones who do it best are usually those with enough humility to get out of people's way.