Tevi Troy writes for Commentary magazine about the next president’s task of addressing significant health care problems tied to the Affordable Care Act.

Obama failed to address the long-term crisis in funding Medicare even as he layered an expensive and severely flawed new benefit for all Americans on top of it. And as he fiddled, the overall national debt significantly incurred by increases in health-care spending grew without letup by about $11 trillion. That is more than the accumulated total debt that had accrued in the administration of every previous U.S. president in our history combined.

The looming budgetary tsunami that will follow from this level of indebtedness will make landfall during the years from 2025 to 2035. In 2025, Medicaid spending will go above $1 trillion for the first time. By 2026, all of the baby boomers will have retired and will no longer be in the labor force. In 2028, the Medicare hospital trust fund will be rendered insolvent. If the predictions of the Obama team are accurate, far more Americans will then be in health plans largely managed and run by the public sector—just as the public sector’s spending on health care will overwhelm the federal government.

The responsibility for all this belongs to both parties, across multiple administrations and Congresses. But our outgoing president had a unique opportunity to deal with many of these problems and either ignored them or made them worse. He entered office with a mandate to do something about health care, and a readiness on the part of the American people to look at a reasonable option for getting that done. Unfortunately, the plan he did pursue, known now and forever as Obamacare, was not only costly, clunky, and complicated; it has also proved corrosive. The partisan way in which he passed it exacerbated tensions in Washington, made it less likely that the American people would accept it, and poisoned bipartisan relations so profoundly that it will now be harder to undertake the repairs that are needed both in the near and immediate future. …

… The highly touted exchanges are the true center of Obamacare, and the picture they present is not a pretty one. The opening of the exchanges in the fall of 2013 proved that the warnings conservatives have long issued about the incompetence and ineptness of government were, if anything, an understatement. The sign-up mechanisms did not work, the waits were lengthy, and the inability to just check prices without disclosing one’s personal financial situation made one wonder if the geniuses behind the system had ever even heard of Amazon.com.

The reaction across the board to the rollout of the exchanges was brutal, and deserved. While no one talks about the disastrous rollout three years later, it did have real and long-lasting effects. First, to the extent that the buy-in on the exchanges is lower than the administration anticipated, that surely stems in some measure from their awful launch. In addition, one has to wonder if the disaster cemented an already extant sense in the American consciousness that government is just not capable of taking on and solving the complex problems of 21st-century America. To the extent that future presidents come up against a wave of skepticism regarding ambitious plans for new government initiatives, the Obamacare rollout will bear much of the blame.