Since President Obama took office the percentage of uninsured people in America has been steadily raising and has now reached a new high. From Gallup:

Monthly averages of percentages without health insurance

This rise in the number of uninsured is for the most part not the fault of the Obama administration. It is primarily the result of long term trends, rising health care costs, and the huge spike in unemployment during the economic crash, as workers lost their employer-provided insurance. Some smaller aspects of the Affordable Care Act, like young adults staying on their parents’ plans, have even helped keep the level of uninsured from going even higher.

Still this development is deeply problematic for Mr. Obama. One of his biggest accomplishments that supporters tend to point to is his passage of the Affordable Care Act and its health insurance reforms.

I simply don’t know how the Administration can successfully campaign on passing a law to expand coverage, when the level of uninsured has increased significantly during Obama’s tenure. It is tough for people to see such a law is any form of a real accomplishment when over a year after its passage it hasn’t even begun to accomplish its main promises and the exact opposite is taking place in people’s lives.

Instead of campaigning on delivering for the American people with his signature legislation, Obama will be forced to explain that even though the insurance situation has gotten worse, voters need to trust his claims that his signature law will eventually improve things in the future.

“Eventual change in the future I hope you believe me about” just doesn’t have that nice campaign ring to it.

The decision to delay the start date of the primary expansion in the Affordable Care Act until 2014 should be remembered as one of the most idiotic political and policy decisions ever made. I would argue that if Obama narrowly loses in 2012, it could be the single decision that is most responsible.

The Administration reportedly supported the delays to hold down near-term costs and achieve a more favorable 10-year cost estimate from the CBO.  Almost no one will remember the bill’s official CBO score come November 2012, but plenty of people will remember they haven’t seen any tangle benefits from the law Obama spent a year working on in the middle of an economic and unemployment crisis.