It's as though two completely separate conversations have been going on. From day one, the health policy community has correctly seen the Affordable Care Act as an attempt to completely change the health care system. This isn't even controversial. It's accepted by all as an undisputed fact.
However, no one has ever said this to the American people. In fact, the message of the Obama presidency — going all the way back to the 2008 campaign — was just the opposite. In that election, Barack Obama rejected Hillary Clinton's call for an individual mandate (a proposal that would obviously affect everyone) in favor of his own proposal which appeared to mainly help those who couldn't afford insurance. And how many people would that be? You could be forgiven if you thought it was about 10% of the population.
Then, on the eve of the passage of the ACA, virtually every Democrat who appeared on TV to defend it had one and only one message to offer: people were being discriminated because of pre-existing conditions. And how many of those people are there? Well for the first three years under the law, anyone denied insurance because of a pre-existing condition was able to enter the new (ObamaCare) risk pools and pay the same premium a healthy person would pay. How many did that? About 107,000. That's out of a U.S. population of approximately 314 million!
To allay concerns about ObamaCare's individual mandate, the president repeatedly promised that "if you like your health insurance plan you can keep your health insurance plan" and "If you like your doctor you can keep your doctor." Over and over again the message was the same: most people will be completely unaffected by the new health law.
Then over the past week or so, the general public woke up to some stunning revelations. It now appears that as many as 10 million people will lose their individual health insurance policies as of January 1. To put this number in perspective, the administration's goal for next year is to sign up 7 million people. We could actually end 2014 with more people uninsured than there were at the end of 2013.
On top of that, The Washington Post has just awarded the president Four Pinocchios for his statements. Although it took them five years to do so, when they finally got around to it the write up was devastating. "Four Pinocchios" is a nice way of saying that the president has been lying all along. [Or, is it possible the president didn't know? More on that below.]