“I think she looked at the data and looked at what would happen if they didn't expand Medicaid,” says Dr. Dan Derksen, director of the Center for Rural Health at the University of Arizona in Tucson. “She built a coalition and moved this through and should be basically commended for a job well done.”
Derksen says he's attended Republican governors meetings where attendees such as Louisiana Gov. Bobby Jindal (No. 70 in this year's ranking) sound “like Winston Churchill,” vowing to fight implementation at every step. Obama alluded to comments like those in his weekly address Aug. 17: “A lot of Republicans seem to believe that if they gum up the works and make this law fail, they'll somehow be sticking it to me, but they'll just be sticking it to you,” the president said.
In the GOP response, Rep. Shelley Moore Capito of West Virginia, disagreed—and she used a remark by Senate Finance Committee Chairman Max Baucus (D-Mont.)—to make her case. “The president claims this law is 'working the way it's supposed to,' but clearly it's not,” Capito said. “Not when the administration is missing deadlines, issuing waivers, and granting delays hand over fist. Things have become so bad that the administration wants to rely on the 'honor system' to verify who is eligible for subsidies. Sen. Max Baucus was right about this law he help write: It's a 'train wreck.' ”
Baucus, who made his eighth appearance on the Most Influential list, placing at No. 36, did not actually describe the law that way. He said he was voicing his concerns to HHS Secretary Kathleen Sebelius about public confusion over the law's implementation. “As you somewhat know, Madam Secretary—I'm a bit Johnny One-Note on implementation of the law, especially with respect to signups and exchanges, etc., and am very concerned not enough is being done so far,” Baucus began.
“I just tell you, I just see a huge train wreck coming down,” he said. “You and I have discussed this many times and I don't see any results yet. What can you do to help all these people around the country going, 'What in the world do I do and ... how do I know what to do?' ”
Baucus tried to clarify his remarks with a news release stating his concern about how the administration must improve its public outreach and saying “This is a good law but it can't work if people don't understand it.”
It was too little, too late. Even Sen. Charles Grassley (R-Iowa), the only elected official to make the Most Influential list all 12 years, piled on. While serving on the Finance Committee leadership as the ranking Republican senator, Grassley, who holds the No. 77 spot on this year's list, worked closely with Baucus to craft bipartisan legislation. Despite their long working relationship, Grassley apparently found the remark too juicy to let go. “The rocky implementation of the Affordable Care Act has been described by a leading Democratic senator as a 'train wreck,' ” Grassley said in July. “Again, that should come as no surprise as passage of the law was railroaded through Congress without the American public on board.”
Follow Andis Robeznieks on Twitter: @MHARobeznieks