NBC's Idea of ObamaCare 'Reality Check': Talk to Its Biggest Supporters

Published: 12/3/2013 10:19 AM ET

Senior News Analyst

In a segment on Sunday's NBC Meet the Press that host David Gregory laughably billed as an ObamaCare "reality check," he invited two of the law's biggest supporters to deliver White House spin, former administration health policy advisor and brother of the President's former chief of staff Dr. Ezekiel Emanuel and liberal Washington Post blog editor Ezra Klein. [Listen to the audio]

Referring to the supposed fix to HealthCare.gov, Gregory teed up Emanuel: "Is it good enough progress?" Emanuel predictably replied: "I think it's good enough progress. Clearly, just like Google and Facebook and all the internet sites are constantly tweaking their sites, constantly improving them, this one still has a ways to go. But it is certainly working reasonably well....So I think actually we are going in the right direction."

In a November appearance of FNC's The Kelly File, Emanuel bizarrely attempted to blame the ObamaCare mess on Fox News "constantly criticizing" the law.

In response to Gregory wondering if young people would sign up for ObamaCare, Klein touted the Orwellian effort by the White House to manipulate the populace:

A couple months ago, before the Obama administration believed that the fall would be all about Obamacare not working, they believed it would be all about a massive outreach effort that they were going to launch using mayors, using governors, using nonprofit groups, and focusing on sort of the TV shows young people watch on social networks, trying to get their mothers involved, to get folks to sign up by getting trusted validators to talk to them about it. That – the website is now working well enough that they are able to launch that campaign, and so they will.

Emanuel went on to make rosy predictions about the impact of the law: "...over the next few years, and then to the end of the decade, this is gonna have a dramatic improvement. It's gonna lower costs. You're gonna have competition in the exchanges, that is already keeping insurance costs down, and gonna keep them down further. You're having improvements in the health care system."

Near the end of the segment, Klein scolded the American people for objecting to the massive disruptions ObamaCare has caused:

One thing that I think it's frustrating in this debate is that we have gotten to a place in politics where we refuse to accept the fact of any kind of disruption in the reform....The individual market is a place where the reason prices are what they are is we discriminate against the sick and the old and women and people who can't read the fine print of insurance. We are fixing that. And it's going to be important that we fix it. It doesn't mean no one will have a tough time in the changeover. And we need to help those folks. But we also need to recognize, if we're gonna make big things better, there's gonna be a process of difficulty as we do that. Otherwise, we're just embracing the status quo for ever and ever and ever.

After Gregory began by claiming the exchange would be a "reality check" about ObamaCare, he ended the segment by remarking on how well Emanuel and Klein read from the White House script: "...this is, I think, really where the administration wants to argue the plus-side that you've already seen on the Affordable Care Act, and argue the real peril of the status quo."

In the segment immediately preceding the exchange, Gregory cut off Republican Congressman Mike Rogers as he tried to inform viewers about further damage ObamaCare would inflict.

Here is a full transcript of the December 1 segment:

10:41AM ET

DAVID GREGORY: Let's get more of a reality check. I want to turn to – now to Dr. Ezekiel Emanuel, who is a former health policy advisor to President Obama, now a professor at the University of Pennsylvania, and also here is editor of The Washington Post Wonkblog, Ezra Klein, who has been closely tracking the progress of the health care rollout. Welcome to both of you.

So the reality test. Here's the report saying, "Dramatic progress, substantial progress, more work to do." Zeke, you wrote in an op-ed some weeks ago that this was the time, Thanksgiving weekend, this deadline is here. Is it good enough progress?

DR. EZEKIEL EMANUEL: I think it's good enough progress. Clearly, just like Google and Facebook and all the internet sites are constantly tweaking their sites, constantly improving them, this one still has a ways to go. But it is certainly working reasonably well. I, in particular, want the "shop and compare" to improve. The White House has said that it's going to improve either later tonight or tomorrow. That's a key area where people can just go and see what's available, what the prices are. It hasn't been working that well, but they're promising to have it improve.

So I think actually we are going in the right direction. And for the first time, and most importantly, we actually have effective management overseeing. We have an integrator that's independent and that seems to be very effective in Optum, as opposed to having CMS run it.

GREGORY: The lag effect of all of this, do people – are they still going to have confidence enough, especially young people, to go and actually sign up, Ezra?

EZRA KLEIN: Well, at some point, they're gonna need to. So there are three things getting folks to sign up, right? On the one hand, there are subsidies. The Congressman [Mike Rogers, R-MI] mentioned the reason people don't get health care insurance is cost. Well, for a lot of those folks, they're gonna get hundreds of billions of trillions of dollars – not individually, but in the market as a whole – of subsidies. So they're gonna find they're gonna have a good deal. And that's the reason they're gonna go in and be part of it.

Another piece of it, of course, is the individual mandate. You guys were talking about this a couple of moments ago. But at the end of this year, in 2014, you're gonna be paying a percentage of your income, a percentage point of your income, if you don't sign up for health care insurance. So that gets you into the market, too.

And then the other thing that has not launched yet, and we don't know how effective it will be. But a couple months ago, before the Obama administration believed that the fall would be all about Obamacare not working, they believed it would be all about a massive outreach effort that they were going to launch using mayors, using governors, using nonprofit groups, and focusing on sort of the TV shows young people watch on social networks, trying to get their mothers involved, to get folks to sign up by getting trusted validators to talk to them about it. That – the website is now working well enough that they are able to launch that campaign, and so they will.

EMANUEL: I mean the other point of go is we do have a data point, which is California, where the website is working well enough. And there, the proportion of kids who are signing up is the proportion of kids in the population. And so it does appear that we are gonna have enough when you look at that data point. And if we can get the word out, I think Ezra is right, we'll get enough young people.

GREGORY: When you hear the politicians, who were just talking, and you hear the debate, the political debate, and a lot of my viewers have got to be hearing that, saying, "I just don't get the bottom – what about whether this is actually gonna get solved?"

EMANUEL: Oh, the website, no doubt, is gonna get solved. That's a technical problem, and they do-

GREGORY: But then there are the other tests down the road.

EMANUEL: Of course there are other tests down the road. But on the long run...

GREGORY: Yeah.

EMANUEL: ...over the next few years, and then to the end of the decade, this is gonna have a dramatic improvement. It's gonna lower costs. You're gonna have competition in the exchanges, that is already keeping insurance costs down, and gonna keep them down further. You're having improvements in the health care system. Hospitals have to work on infections, readmissions. And you are getting a lot more rationalization...

GREGORY: But, alright-

EMANUEL: ...price transparency.

GREGORY: But there is a more pessimistic case, which could be what?

KLEIN: The more pessimistic case could be that you would have employers begin to move people out of employer-based insurance and into the exchanges. I actually think – and a funny thing about this debate is that Republicans believe that would be, over time, great. All their plans, including Paul Ryan's 2009 plan, were about breaking down the employer – the tax breaks for employer-based insurance and moving people over. One thing that I think it's frustrating in this debate is that we have gotten to a place in politics where we refuse to accept the fact of any kind of disruption in the reform. There can only, only, only be-

GREGORY: Be smooth reform, right.

KLEIN: The individual market is a place where the reason prices are what they are is we discriminate against the sick and the old and women and people who can't read the fine print of insurance. We are fixing that. And it's going to be important that we fix it. It doesn't mean no one will have a tough time in the changeover. And we need to help those folks. But we also need to recognize, if we're gonna make big things better, there's gonna be a process of difficulty as we do that. Otherwise, we're just embracing the status quo for ever and ever and ever.

GREGORY: And this gonna – I'm out of time, but this is, I think, really where the administration wants to argue the plus-side that you've already seen on the Affordable Care Act, and argue the real peril of the status quo. I've got to leave it there. But Zeke Emanuel, Ezra Klein, thank you both very much for being here.