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Could Obamacare Have Been Better?

Even with the Affordable Care Act, about half of America's uninsured will not be helped, and many people with employer-provided insurance will face rising premiums.

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We do know, in response to point two, that the ACA makes a dizzying complex system that much more complex. And far from gradually displacing the inefficient central role of private insurance companies, the ACA reinforces that role.

As for points three and four, it's true that the ACA will help a lot of people and that the cursed website healthcare.gov is slowly becoming operational. People with pre-existing conditions, people under 26, people who lose health insurance when they change or lose jobs, will all be helped. Small business will eventually be helped, too.

But about half of America's uninsured will not be helped, and a lot of people who have employer-provided insurance will find their premiums rising. (The Wall Street Journal recently reported that because the mandate will cause more employees to sign up for company-provided insurance that they previously declined, employer costs will rise and businesses are planning to pass these higher costs along to all employees through higher premium-shares, deductibles and co-pays. Obama and Democrats are likely to get the blame.

So even if Obamacare does help a lot of people, my question was and is: at what political cost and at what long-term cost to effective social insurance? Both the conception and the roll out of The Affordable Care Act will set back the effort of liberal Democrats to persuade regular people that government can be a force for the broad public good (Social Security has no such problems). The ACA is the social-policy equivalent of the Pentagon's apocryphal $800 hammer. Even with a great deal of catch-up and good luck, it will take a miracle for Obamacare not to be a net loser for Democrats in the 2014 mid-term elections.

I don't buy the argument that liberal commentators like me have some kind of obligation to stand by their president when he messes up. As the terrific reporting of the New York Times has demonstrated, the failure to get the website up and running was substantially preventable and politically inept if not inexcusable.

Nor do I accept the charge of piling on, or reveling in the role of I-told-you-so.

Despite the debacle, I am with my friend Hank Aaron in hoping that they fix this mess, the sooner and more effectively the better -- because the failure of the ACA taints reformers who are more resolute in their progressivism than the Rube Goldberg imitation of liberal government that bears our president's name.

Robert Kuttner is the former co-editor of the American Prospect and a senior fellow at Demos. His latest book is "Obama's Challenge: America's Economic Crisis and the Power of a Transformative Presidency."