My Berean brother, Dr. Haymond, rightly criticized President Obama’s leadership in the Affordable Care Act’s less than optimal rollout. But as he acknowledges in the comments section of the post, things seem to have taken a darker turn.

NBC News, not exactly a fountain of right-wing mouth-froth, is now reporting that President Obama’s Administration was aware, as early as 2010, that large numbers of those currently insured would lose coverage and be forced into alternative plans. Now we know those alternative plans are also far more expensive. Even Democrats are dissembling, attempting, like Steny Hoyer, either to nuance the claim, saying it was not a lie but “imprecise,” or, like Mary Landrieu, they are distancing themselves from their own claims.

Many laws have unintended consequences. Things happen that are difficult to foresee. When Social Security was implemented, for example, family habits transitioned away from multi-generational dwellings, where adult children and their parents often lived together, and toward arrangements that isolated the elderly because they now had a small government pension. While this phenomenon took place in the context of increased mobility and life spans, and shifting mores, so it is impossible to nail down the relationship in a causal sense, Social Security made this behavior more likely. To a degree, then, shifting family patterns were an unintended consequence of what was a well-motivated policy.

Recently, the cash-for-clunkers program had similar, but probably easier to predict, consequences. If you don’t recall, as part of the stimulus package in 2009, the federal government provided a rebate of up to $4,500 to people who traded in their low miles-per-gallon used cars for more fuel-efficient models. Dealers, to secure the rebate, were forced to destroy the engines of the cars being traded in and then they could make them available for junkyards or recyclers. While the program was designed to stimulate the economy and increase overall fuel efficiency, one of the consequences was that it took tens of thousands of affordable used cars from the market and thereby drove up prices for low-income families in need of a cheap car. Obviously, this was not ideal during a time of severe recession, especially when transportation and employment are so closely bound for so many.

Again, all of this to say that programs have consequences that are intended and unintended. As believers, we should extend grace to our leaders who make decisions with an imperfect understanding of what might occur. What we should demand, however, is honesty about the intentions behind policies and the competence to forecast reasonably what could happen as a result of the new law, both positively and negatively.

In 2009, during the raging debate that surrounded health care reform, President Obama claimed, repeatedly, that Americans would be able to stay in their current plans if they wished to do so AND that the reforms, once enacted, would lower health costs in general. As of 2010, at least, the NBC report claims the Obama Administration had a reasonable grasp of what would occur–canceled policies and higher costs for many individuals and families. We do not know, as far as I can tell, when President Obama was made aware of these predicted outcomes, but, as the NBC report notes, he repeated the bromides to anyone with a high-definition camera as late as 2012. What was happening in 2012? Oh yeah, an election.

We are confronted with two options. Either he was not aware of the mismatch between his rhetoric and reality, and he is an extraordinarily dull man, unable to hold his staff accountable, or he knew and simply chose to lie about it. Always. Neither outcome brings comfort, even to the President’s staunchest defenders.

What we have, it seems, is an administration that is able to forecast the most likely outcomes connected to the Affordable Care Act, but unable, either by executive incompetence or rank dishonesty, to grapple with those forecasted outcomes with anything resembling integrity.