For nearly four years, President Obama has frequently offered some variation of this promise about the Affordable Care Act: "If you like your health-care plan," as he said in a speech to the American Medical Association in June 2009, "you'll be able to keep your health-care plan, period. No one will take it away, no matter what."
NBC News caused a kerfuffle on Monday when it reported the Obama administration knew for years that millions would be forced off their preferred insurance plan. This hardly amounts to a revelation: the president and his people, along with Democratic Party leaders, had to know that this would happen.
For example, in a Dec. 19, 2009 letter to Senate Majority Leader Harry Reid, the Congressional Budget Office noted that the Affordable Care Act would cause between eight and nine million Americans to lose their employer-provided coverage either by "the dropping of existing coverage or a lack of new offers of coverage."
Three days before Mr. Obama signed the law, CBO and the congressional Joint Committee on Taxation reaffirmed these numbers in a March 20, 2010 letter to then-House Speaker Nancy Pelosi. A month later, the chief actuary at the Department of Health and Human Services' Centers for Medicare and Medicaid Services estimated that 14 million would lose their employer-provided insurance.
There were also warnings that higher premiums, mandated benefits and other regulations would cause many of the roughly 15 million Americans who individually purchase health insurance to lose their policies.
It is inconceivable that the president, his top aides and Health and Human Services Secretary Kathleen Sebelius, didn't know about all this. Which raises these questions: Why did Mr. Obama keep saying something that was simply not true? And how did his administration allow him to do so?
Every presidential speech is rigorously reviewed. Indeed, top aides throughout the West Wing and officials elsewhere in the government receive draft presidential remarks for review. Comments about facts, tone, words and phrases are collected, reviewed and either adopted, amended or rejected. A new version of the speech is then prepared. In nearly seven years at the White House, I saw this process in action virtually every day.
Either Mr. Obama's staff did not know about the CBO estimates (hardly likely), or they did not care the president was routinely offering a politically convenient falsehood (seems right), or they did not have the fortitude to tell the president that what he was saying wasn't true (also probably so). Neither ignorance, arrogance nor sycophancy is an excuse for such presidential dissembling.
This is a serious breach of trust with the American people. Yet virtually every other major promise Mr. Obama has made about his health-care reform—for example that you can keep your doctor, that your premiums will go down, that overall health spending will decline—is also untrue.
There is also a bigger question. If the White House cannot run a routine review process for the president's speeches, how is its policy process conducted? There is so much about Mr. Obama's actions that appears haphazard or impetuous that it raises concerns he is sitting atop a policy process that is staggeringly inept.
It's not just ObamaCare's incompetent implementation. Many of Mr. Obama's other policies—the lack of "shovel ready jobs" in the huge stimulus bill, drawing and then erasing red lines in Syria, the near-criminal negligence surrounding the terrorist attack in Benghazi, the IRS targeting of conservatives, the president spinning his wheels on gun control and failing to achieve immigration reform—all of this and more smack of impulsive action, indifference and lack of attention.
There were concerns during the 2008 campaign that Mr. Obama was not prepared to be president, that his ability to give an inspiring speech would not automatically translate into the ability to competently govern. What has surprised even many of his critics is that Mr. Obama doesn't seem to have learned much. He is as clumsy and amateurish now as he was in January 2009. That's led to sloppy deceptions such as "if you like your plan, you can keep it" and a host of other claims about health-care reform. It may also produce many more incompetent policies.
We can only hope voters remember this the next time a well-spoken community organizer decides he wants to be president.
A version of this article appeared October 31, 2013, in the U.S. edition of The Wall Street Journal, with the headline The President's Broken Health-Care Promises and online at WSJ.com.