Game Over For Obamacare Saboteurs?

n this photo taken Thursday, April 11, 2013 Liz DeRouen, 49, left, gets her blood pressure checked by medical assistant Jacklyn Stra, right, at the Sonoma County Indian Health Project in Santa Rosa, Calif. When DeRou... n this photo taken Thursday, April 11, 2013 Liz DeRouen, 49, left, gets her blood pressure checked by medical assistant Jacklyn Stra, right, at the Sonoma County Indian Health Project in Santa Rosa, Calif. When DeRouen needs any kind of health care services, from diabetes counseling to a dental cleaning, she checks into a government-funded clinic in Northern California's wine country that covers all her medical needs. Her care and the medical services for her children and grandchildren are paid for as part of the government's obligations to American Indian tribes dating back nearly a century. But under President Barack Obama's health care overhaul, DeRouen and tens of thousands of others who identify as Native American will face a new reality. They will have to buy their own health insurance policies or pay a $695 fine from the Internal Revenue Service unless they can prove they are "Indian enough" to claim one of the few exemptions allowed under the Affordable Care Act's mandate that all Americans carry insurance. MORE LESS
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You may have seen this news yesterday, but if you missed it, please click through and give it a read.

The spoiler version is that out in California, where the state government and advocacy groups are actually interested in doing Obamacare right, things are looking pretty good. They’re standing up their exchanges and it turns out premiums for basic bronze and more comprehensive silver health plans will actually come in lower than anticipated.

This is almost unambiguously good news for Obamacare.

You can tell it’s good news because it’s obviously good news, but also because the brigade of conservative writers who comb the news for every last Obamacare glitch in less cooperative states have been pretty quiet about it.

But in addition to auguring well for the law and suggesting its detractors have been blowing implementation problems out of proportion, I think this news underscores the strategic importance, from the administration’s point of view, of getting the ACA right in California in particular.

For those following ACA news closely, I’d almost say forget everything you hear about the law outside of California.

California is huge, geographically and population-wise. Yet it’s better positioned than almost any state in the US to implement Obamacare smoothly — Democratic leadership, big activist networks, etc. If they can make this work, then a). the law will have a huge head start toward meeting it’s national coverage goals and b). it will serve as a model for every other state in the country for how to make it work.

More to the point, all the states trying to make the law fail will look very stupid and terribly craven if California pulls this off. Their predictable claims that Obamacare is all screwed up won’t be very persuasive if a giant, historically mismanaged state like California can make it work well.

If it fails in California, though, that’s a disaster.

Thus, my hunch is that both the administration and California officials are unusually invested in getting it right there, more so than in any other state in the union. The other side of that coin, of course, is that conservatives will be heavily invested in finding ways to undermine it. Perhaps that’s why they’ve recently tried recently, and appropriately, to make issue of California’s attempt to conceal its exchange’s contractor spending from the public.

But if you’re looking for an Obamacare bellwether, keep your eyes on California.

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