- The President has unfettered use of the Executive Order to accomplish whatever he wants. He has said as much himself, and Congress has thus far done nothing to indicate that they have the motive, heart or courage to challenge his use of the EO to govern as an unrestrained monarch.
- The ACA gives the Secretary of Health and Human Services (HHS) absolute freedom to unilaterally do whatever the Secretary (and thus the President) deems necessary to implement the Act, including amending the Act itself without the participation of Congress.*
- President Obama has no qualms about using the IRS, NSA, Justice Department, Labor Department, NLRB or any other Agency to further his agenda or accomplish his objectives.
- The implementation of the ACA has been a disaster, not just in its technical implementation, but in its failure to enroll the right types of people in the right numbers to make the program "work."
Given the facts enumerated above, here is what Obama could do (notice that I said "could" and not "should," as I think the whole shebang is illegal and unConstitutional to begin with). Later on, I will tell you why I think he has not done these things up to this point (Preview Hint: Things are going exactly according to plan and he is waiting for a Congressional consensus that the single-payer system is the only solution to the mess that Obamacare has made of American health care and the insurance industry).
- Expand the program to require all employers that have one or more people working directly for them to carry insurance, and make employee participation mandatory. Since employers already collect premiums and remit them to the insurance carriers, this would ensure that every working person of any age is a paid-up participant, including the young, healthy people that must enroll in order for the program to "work." This step alone would result in the paid enrollment of 50 to 80% of the population, depending on whose labor force numbers you trust.
- For the unemployed who are legal residents, use every Agency that dispenses any type of welfare assistance to automatically enroll the person receiving the entitlement. If you receive food stamps, housing assistance, student loans, earned income tax credits, unemployment insurance, research grants, SBA loan, FHA mortgage or any of the other myriad federal handout programs, the agency that dispenses the benefit would check the healthcare.gov database to see if you are currently enrolled, then enroll you if you are not. No asking you if you want to participate, just enroll you, then notify you. Period. Done.
- Make participation in the program mandatory for all federal, state and local government employees.
- Amend the Act to require that everyone working or living in America file an Income Tax return or be included on someone else's return. Then further amend the act to make failure to pay the "fine" (tax) a punishable crime, just like failure to pay your income tax is punishable. The ACA already gives the President the power to hire as many IRS agents as it takes to implement the Act, why not add a few thousand more jack-booted thugs to collect the booty?
In a nutshell, President Obama and the HHS have the (questionably constitutional) power and authority to make the program "work." Combine that fact with the fact that President Obama now has practically dictatorial power to do whatever he likes, and you have a winning plan for fixing the current woes of Obamacare.
So why does he not do some or all of the above? It cannot be that neither he or his advisors and congressional minions have not thought about them. If they can come up with a 2,000-page bill and expand it to 7,000 pages in a scant four years, surely they could come up with the same proposed fixes on their own. But that presupposes that they WANT the ACA to work the way they SAY they want it to work. The truth is, as some are beginning to point out, that "working" was not the main objective when the ACA was passed by employing as much or more political chicanery as ever was used to pass a law in this country. The overarching objective was to force everyone into a single-payer, government-provided insurance system. The beauty of The ACA , to those who wrote and passed it, is that single-payer is the inevitable end if the Act is implemented as originally written, and single-payer is the inevitable end if the Act falls apart as originally written.
And that, my friends, is why President Obama has the power to make the ACA work in its present incarnation, but for now he does not have the compulsion or inclination to use all the unprecedented power at his disposal force it to work as written. Allowing the ACA to collapse of its own weight and get replaced with single-payer is the most politically-expedient and legacy-preserving way to get what he wants. But either way, fix it now unilaterally or fix it later with congressional blessing when it completely collapses of its own weighty ineptitude, he gets single-payer.
*The many calls for Congress or the States to challenge the President's willy-nilly changes to the law are coming from people who still have not read the Act to see what's in it. One more time, from the top: The law gives the HHS Secretary and the President the right to do whatever they want without consulting Congress.