The journalist Jonathan Cohn, an ardent supporter of Obamacare, recently wrote in The New Republic that problems with the rollout of the Affordable Care Act should be "an opportunity to have a serious conversation about the law's trade-offs -- the one that should have happened a while ago."
Cohn is right that there was no serious conversation about those trade-offs back when Congress was considering the law's passage in 2009 and 2010. But why was that? It was because President Obama and his Democratic allies could not speak seriously -- and honestly -- about those trade-offs and still pass their bill.
So instead, Obama assured Americans they could keep health care policies they liked. And it wasn't just Obama. "One of our core principles is that if you like the health care you have, you can keep it," Senate Majority Leader Harry Reid said in August 2009. "If you like what you have, you can keep it," said then-House Speaker Nancy Pelosi in October of the same year.
Many, many Democrats promised the same thing. They had to. If they had declared openly that millions of Americans would lose their current coverage and face higher premiums and deductibles -- if Obama and Democratic leaders had said that, they would not have been able to maintain party unity in support of the bill, and the Affordable Care Act would never have passed Congress.
It would not have mattered that Republicans opposed the bill unanimously. A frank public discussion of Obamacare would have divided Democratic support, with the result being no new law at all.
But now, as the reality of Obamacare begins to present itself in the lives of millions of Americans, the president and his party can no longer avoid an honest look at the law they passed. And one part of that honesty will be examining what they said when they passed Obamacare. There will likely be a lot of accountability in coming months.
For example, CNN's Jake Tapper recently asked Rep. Steve Israel, a leading congressional Democrat, whether the bill's supporters "were as forthright about some of the issues as they could have been" during the Obamacare debate. Tapper specified not just the president's keep-your-coverage promise but "some of the trade-offs" of the law that favor some Americans over others. "If you could go back in time, do you think there should have been more honest salesmanship?" Tapper asked.
"Well, there should have been certainly more precise education and more precise salesmanship, there's no question about that," Israel said. "But you can't go back in time."
Yes, you can. Not literally; of course Democrats can't have a do-over. But the American people can certainly go back in time and examine the Democratic sales job for Obamacare in light of today's reality. The president and his party knew full well the trade-offs they were making; they just didn't tell the rest of the country.
All during the debate, Democratic officeholders, aides, policy wonks, advocates and sympathetic journalists all knew coverage cancellations would be coming as part of Obamacare. Of course, the president knew, too. When Obama made the keep-your-coverage promise, over and over, those Washington insiders accepted the untruth as a necessary part of the process, something Democrats had to do to pass their bill.
But millions of Americans didn't get the memo and took Obama at his word. And now that the promise has been proven false, the president is trying to recover his credibility -- his desire to do so was painfully evident at his long and sometimes rambling news conference -- and his party is searching for cover.
There won't be any. In coming days, Republicans, who voted unanimously against Obamacare, will be happy to remind the public of what Democrats promised. On Thursday afternoon, for example, the House GOP leadership published a list of quotes from 61 House Democrats pledging that if Americans liked their health coverage they could keep it. And in the Senate, for those vulnerable Democrats up for re-election in 2014, the accountability could be quite painful indeed.
The situation could become infinitely worse if problems now plaguing the individual insurance market begin to infect employer-based insurance, which covers by far the largest number of Americans.
In response, Democrats will no doubt talk a lot about various measures to "fix" this or that part of Obamacare. But voters will know that those Democrats are just seeking to clean up a mess they made in the first place. The political price to be paid could be very, very high.