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Stop Waiting for Obamacare to Implode
http://www.bloombergview.com/articles/2014-04-01/obamacare-s-naysayers-should-concede-defeat?cmpid=yhoo
543 Apr 1, 2014 4:04 PM ET
By Ramesh Ponnuru
In late September, right before the Affordable Care Act's insurance exchanges opened, Health and Human Services Secretary Kathleen Sebelius said that success for the new law would look like "at least 7 million" enrollees.
The White House spent much of the time between then and now trying to walk back that declared goal, but now it has reached it (ignoring, as the Barack Obama administration mostly does, the question of how many of those "enrollees" have paid or will pay their premiums). Congratulations, Madam Secretary.
Hitting that goal was important as a political matter, and as a sign -- but not a guarantee -- that the exchanges would be actuarially stable. We don't know yet how many of them will be: We'd need to know the mix of healthy and sick enrollees in each state to make that judgment. We also don't know for sure how many of the enrollees were previously uninsured. And we want to know how well the law has done in achieving its larger goal of increasing coverage, not just of making itself sustainable.
But it's clear now that one scenario with a lot of purchase among conservative opponents of Obamacare -- that the law would "implode," "collapse" or "unravel" -- is highly unlikely. A quick death spiral was always a remote possibility, even if the early troubles of the exchange websites made it look a little less remote. Many congressional Republicans wanted to believe the idea, though, especially because they viewed it as one more reason they could avoid coming up with their own health-care agenda. (This was illogical -- if the program was going to self-destruct in months, wouldn't the country need a replacement ready? -- but the psychological impulse was to avoid grappling with health-care issues.)
Supporters of Obamacare see the enrollment numbers as more evidence that the law is here to stay. Of course, those numbers don't give us any reason to think that the law will do a lot of good at a reasonable price, or that its basic structure can be modified to pass that test. But the supporters are right that meeting the target of 7 million enrollments will make repealing and replacing the law harder.
The likelihood of replacement would be higher if there was an alternative that didn't take away people's insurance -- one that promised to cover roughly as many people as Obamacare does, or even more. Letting people on Medicaid buy into the market by converting much of the program into tax credits, for example, would be more viable than just kicking its new beneficiaries off the rolls.
Opponents of Obamacare should always have been thinking along these lines. Now they have less and less choice.
543 Apr 1, 2014 4:04 PM ET
By Ramesh Ponnuru
In late September, right before the Affordable Care Act's insurance exchanges opened, Health and Human Services Secretary Kathleen Sebelius said that success for the new law would look like "at least 7 million" enrollees.
The White House spent much of the time between then and now trying to walk back that declared goal, but now it has reached it (ignoring, as the Barack Obama administration mostly does, the question of how many of those "enrollees" have paid or will pay their premiums). Congratulations, Madam Secretary.
Hitting that goal was important as a political matter, and as a sign -- but not a guarantee -- that the exchanges would be actuarially stable. We don't know yet how many of them will be: We'd need to know the mix of healthy and sick enrollees in each state to make that judgment. We also don't know for sure how many of the enrollees were previously uninsured. And we want to know how well the law has done in achieving its larger goal of increasing coverage, not just of making itself sustainable.
But it's clear now that one scenario with a lot of purchase among conservative opponents of Obamacare -- that the law would "implode," "collapse" or "unravel" -- is highly unlikely. A quick death spiral was always a remote possibility, even if the early troubles of the exchange websites made it look a little less remote. Many congressional Republicans wanted to believe the idea, though, especially because they viewed it as one more reason they could avoid coming up with their own health-care agenda. (This was illogical -- if the program was going to self-destruct in months, wouldn't the country need a replacement ready? -- but the psychological impulse was to avoid grappling with health-care issues.)
Supporters of Obamacare see the enrollment numbers as more evidence that the law is here to stay. Of course, those numbers don't give us any reason to think that the law will do a lot of good at a reasonable price, or that its basic structure can be modified to pass that test. But the supporters are right that meeting the target of 7 million enrollments will make repealing and replacing the law harder.
The likelihood of replacement would be higher if there was an alternative that didn't take away people's insurance -- one that promised to cover roughly as many people as Obamacare does, or even more. Letting people on Medicaid buy into the market by converting much of the program into tax credits, for example, would be more viable than just kicking its new beneficiaries off the rolls.
Opponents of Obamacare should always have been thinking along these lines. Now they have less and less choice.
Yes Mrs.P you can keep being a cheerleader for it, but it is not a valid system and no it will not be here to stay. It will either have a major overhaul or will be over turned in 2016.
Everyone knows the system is flawed yet the cheerleaders at the White House and msnbc act like nothing is wrong with it. Yet they can't answer questions about it.
Everyone knows the system is flawed yet the cheerleaders at the White House and msnbc act like nothing is wrong with it. Yet they can't answer questions about it.
It's my understanding that it'll be 1% of income over $10,500.
Its here to stay!..
You wouldn't happen to know what her penalty payment is, would you?
http://www.cnsnews.com/news/article/melanie-hunter/it-s-loss-md-73k-lose-insurance-60k-enroll-exchange
Well Obamacare does need the young and health to sign up in massive numbers because those are the ones that pay and do not use the service. So that is a huge part if it will be remotely successful. But since this just started I am going to give it 1 year and then people will stop paying, and horror stories on care will start to come out.
But as mike correctly points out...time will tell.
And by no means do I think this will be ever close to successful.
But as mike correctly points out...time will tell.
And by no means do I think this will be ever close to successful.
Time will tell - as with all things.
That's just about in line with what is being reported in all the news outlets. 80% have paid their first premium payment, and 20% haven't.
I'm honestly not at all surprised by the 80%. What I'm waiting for, is to see how many make repeat payments (IE: keep up with them).
I don't mean this as a slight on anyone, but everyone goes into payment plans (mortgage, car-payment, healthcare, etc) with good intentions of keeping up with their payments.
I think the percentage of people who KNOWINGLY enter into a payment-plan with the intention of only making their initial/first payment, and scrapping the remaining/balance, is extremely low. Likewise, I think that anyone & everyone that signed up for ACA-coverage is PLANNING on making payments forever & ever amen.
But as we all know... $hit happens (IE: loss of job, sickness in the family, death of a bread-winner, etc, etc). Their intentions are good, but when it comes to deciding whether or not to put rice & beans on the table to feed their children, or turning the lights on & off, or putting gas in the car to get to work, and paying for "just in case" coverage... I think those good intentioned people will chose the former. It'll be through no falt of their own, in most cases, but I really DO think that a lot of people are going to find that they've bitten off more than they can chew (as happened with the housing market/mortgage banking crash).
Making the first payment is easy... making 11 more just like it, and THEN I'll say that the program might be successful.
The ONGOING payment of premiums will be the REAL test of whether or not the ACA is going to be financially viable/sustainable as an institution.
Anyone agree or disagree?
I'm honestly not at all surprised by the 80%. What I'm waiting for, is to see how many make repeat payments (IE: keep up with them).
I don't mean this as a slight on anyone, but everyone goes into payment plans (mortgage, car-payment, healthcare, etc) with good intentions of keeping up with their payments.
I think the percentage of people who KNOWINGLY enter into a payment-plan with the intention of only making their initial/first payment, and scrapping the remaining/balance, is extremely low. Likewise, I think that anyone & everyone that signed up for ACA-coverage is PLANNING on making payments forever & ever amen.
But as we all know... $hit happens (IE: loss of job, sickness in the family, death of a bread-winner, etc, etc). Their intentions are good, but when it comes to deciding whether or not to put rice & beans on the table to feed their children, or turning the lights on & off, or putting gas in the car to get to work, and paying for "just in case" coverage... I think those good intentioned people will chose the former. It'll be through no falt of their own, in most cases, but I really DO think that a lot of people are going to find that they've bitten off more than they can chew (as happened with the housing market/mortgage banking crash).
Making the first payment is easy... making 11 more just like it, and THEN I'll say that the program might be successful.
The ONGOING payment of premiums will be the REAL test of whether or not the ACA is going to be financially viable/sustainable as an institution.
Anyone agree or disagree?
http://www.nationaljournal.com/health-care/15-20-percent-aren-t-paying-obamacare-premiums-insurer-says-20140402
I agree with you - I know it's shocking but it is true.
I don't want the ACA to fail, truly I don't.
The healthcare system in the U.S. was/is a travesty. A 1st-world country in as sad a shape as we are, is a failure of EPIC proportions (and again, the failure starts at the very top of the iceburg).
The premise of 'universal healthcare' and programs like the ACA, is cheap, affordable, quality healthcare for all that want it.
I just don't think that the ACA, in it's current form, comes remotely close to fitting that bill.
The healthcare system in the U.S. was/is a travesty. A 1st-world country in as sad a shape as we are, is a failure of EPIC proportions (and again, the failure starts at the very top of the iceburg).
The premise of 'universal healthcare' and programs like the ACA, is cheap, affordable, quality healthcare for all that want it.
I just don't think that the ACA, in it's current form, comes remotely close to fitting that bill.
El there is so much spin going on to praise this as the greatest thing since sliced bread that big questions are being missed or not answered and those questions being asked we are told are now "excuses". With the media behind this farce of a health care and President we will not know the epic failure until 2016 when a Republican is in the White House.
I should have said:
A link for most of the previous post is:
https://www.debate.org/SmokingGun/forums/
A link for most of the previous post is:
https://www.debate.org/SmokingGun/forums/
A link for most of the subsequent post is:
https://www.debate.org/SmokingGun/forums/
https://www.debate.org/SmokingGun/forums/
The ACA is an epic failure.
Democrats keep scampering about and flashing the number "7 Million" as if it means something significant. Don't get me wrong, 7M is a large number when taken out of context, but let's focus on the bigger picture.
Democrats (and liberal media) claim that approximately 7M people have been enrolled under the ACA in the past 6 months. Now ask yourself how many people live in the United States? According to the U.S. Census, approximately 316.1M individuals live in the United States. That means only 2.2% of all Americans have enrolled under ACA. What about the other 309M Americas? 7M enrollees, when put into this context, is a small fraction of the overall population. The U.S. Census also tells us that roughly 46.2M Americans live in poverty. Optimistically, if all 7M enrollees under ACA were living in poverty, then only 15% of Americans who are living in poverty have enrolled under ACA.
If only 2.2% of all Americans, and only 15% of ALL Americans who live in poverty enrolled under ACA over the course of half a year, how can the Democratic Party claim that the ACA is a success?
The fact is, that 7M Americans enrolled, and 309M Americans did not. 309M Americans would rather keep what they have, or not have healthcare at all.
Maybe Obama's affordable care isn't so "affordable" after all. Maybe this is a sign that Obamacare is just another burden/tax placed on the American people by Obama and his cronies/administration.
Maybe it's more affordable to pay the mandatory fee for not having healthcare, than to pay to have Obamacare.
Epic failure indeed.
*And don't even get me started on the 22M illegal mexicans living in the country that will continue to rape & pillage the already overburdened healthcare system, continuing to get free healthcare on the backs of the underpaid, overtaxed, under represented middle-class American citizens.
This country is broken, and it starts in DC. In the past, the fractures & rifts & breaks have been fixable. We've reached & surpassed the tipping-point, and are too far gone to ever come back. We live in a new America, and we need a new system to deal with it (meanwhile, we're stuck with the old, which is unable to cope with the demands & stresses of said new America).
And if anyone read all of that... you get a lolly-pop!
Democrats keep scampering about and flashing the number "7 Million" as if it means something significant. Don't get me wrong, 7M is a large number when taken out of context, but let's focus on the bigger picture.
Democrats (and liberal media) claim that approximately 7M people have been enrolled under the ACA in the past 6 months. Now ask yourself how many people live in the United States? According to the U.S. Census, approximately 316.1M individuals live in the United States. That means only 2.2% of all Americans have enrolled under ACA. What about the other 309M Americas? 7M enrollees, when put into this context, is a small fraction of the overall population. The U.S. Census also tells us that roughly 46.2M Americans live in poverty. Optimistically, if all 7M enrollees under ACA were living in poverty, then only 15% of Americans who are living in poverty have enrolled under ACA.
If only 2.2% of all Americans, and only 15% of ALL Americans who live in poverty enrolled under ACA over the course of half a year, how can the Democratic Party claim that the ACA is a success?
The fact is, that 7M Americans enrolled, and 309M Americans did not. 309M Americans would rather keep what they have, or not have healthcare at all.
Maybe Obama's affordable care isn't so "affordable" after all. Maybe this is a sign that Obamacare is just another burden/tax placed on the American people by Obama and his cronies/administration.
Maybe it's more affordable to pay the mandatory fee for not having healthcare, than to pay to have Obamacare.
Epic failure indeed.
*And don't even get me started on the 22M illegal mexicans living in the country that will continue to rape & pillage the already overburdened healthcare system, continuing to get free healthcare on the backs of the underpaid, overtaxed, under represented middle-class American citizens.
This country is broken, and it starts in DC. In the past, the fractures & rifts & breaks have been fixable. We've reached & surpassed the tipping-point, and are too far gone to ever come back. We live in a new America, and we need a new system to deal with it (meanwhile, we're stuck with the old, which is unable to cope with the demands & stresses of said new America).
And if anyone read all of that... you get a lolly-pop!
Im not sure what is going on with your friend, but something isnt right there. For starters, in order to get a tax credit, you Must go thru the marketplace in order for IRS to see if you qualify for a tax credit when you file your taxes.
Since those are given by income eligibility, household of one icome limit is almost 46 thousand, size of two is 62 thousand, 3 is almost 79 thous and so on.
There is also many plans to choose from, and I got the silver, and it sounds like your friend got a gold? But regardless, pre existing doesnt even enter into it. They dont even ask if you have any and the only health question they ask is if you smoke because if you do, your premiums will be a certain percent higher. And no, one of the things thru the ACA is you cannot be cancelled or dropped unless you dont pay the premium, so something isnt right with this. Did she get it thru the marketplace cause it doesnt sound like it.
Since those are given by income eligibility, household of one icome limit is almost 46 thousand, size of two is 62 thousand, 3 is almost 79 thous and so on.
There is also many plans to choose from, and I got the silver, and it sounds like your friend got a gold? But regardless, pre existing doesnt even enter into it. They dont even ask if you have any and the only health question they ask is if you smoke because if you do, your premiums will be a certain percent higher. And no, one of the things thru the ACA is you cannot be cancelled or dropped unless you dont pay the premium, so something isnt right with this. Did she get it thru the marketplace cause it doesnt sound like it.
Would you mind telling us what your deductible is?
My friend has no pre-existing conditions at all and her deductible, with a $600/mo plan would be $12K... That means she pays $600/mo, but unless her bills exceeded $12K, the insurance would pay zilch. That's exorbitant for someone with no medical conditions and taking no prescription drugs. I have pre-existing conditions and do take prescription drugs and I don't have that much in medical bills in a year's time.
My friend has no pre-existing conditions at all and her deductible, with a $600/mo plan would be $12K... That means she pays $600/mo, but unless her bills exceeded $12K, the insurance would pay zilch. That's exorbitant for someone with no medical conditions and taking no prescription drugs. I have pre-existing conditions and do take prescription drugs and I don't have that much in medical bills in a year's time.
I used mine for the first time this week. I enrolled back in Nov, paid my premium in Dec to be covered in Jan. My hubby went to the doc, didnt have to wait to get an appointment, was seen right away and is set up for his blood work to be done. He was pleasantly surprised. However, he did say that his perscription prices had doubled but I informed him that he has no perscription coverage until he pays the deductable, LOL!
Ours is an HMO, so we had to establish with a primary care physican first and then be referred to other doctors we used to see so they could get paid.
Then I did my taxes. We made more than we did last year so we may not be eligible for subsidys either, but I will pay for it regardless because having been one that could not get coverage, I feel blessed to be able to get it. Even 5 or six hundred, altho high, is reasonable when you consider that until now, they didnt have to cover ya at all. Hopefully it will tide us over till medicare kicks in. It also pales in comparison to that 100 thousand dollar hospital bill I got a few months ago when I was not insured, but there too, I was blessed that they treated me without having any. I will do my utmost to make those payments even if I have to drop to basic essentials in order to do it.
Ours is an HMO, so we had to establish with a primary care physican first and then be referred to other doctors we used to see so they could get paid.
Then I did my taxes. We made more than we did last year so we may not be eligible for subsidys either, but I will pay for it regardless because having been one that could not get coverage, I feel blessed to be able to get it. Even 5 or six hundred, altho high, is reasonable when you consider that until now, they didnt have to cover ya at all. Hopefully it will tide us over till medicare kicks in. It also pales in comparison to that 100 thousand dollar hospital bill I got a few months ago when I was not insured, but there too, I was blessed that they treated me without having any. I will do my utmost to make those payments even if I have to drop to basic essentials in order to do it.
"Federal officials have set an informal target of 40% of enrollments in the 18-34 age range." Why on earth would anyone between the ages of 18 and 26 sign up for their own insurance, when they can stay on Mom and Dads insurance? Unless, of course, Mom and Dad don't have insurance.
Brice -- the friend I mentioned who would lose her policy if she used it, found out that policy didn't meet the standards of ACA and the next one up that would meet the standards would cost $600+/mo with no subsidy. She's chosen to pay the penalty.
Brice -- the friend I mentioned who would lose her policy if she used it, found out that policy didn't meet the standards of ACA and the next one up that would meet the standards would cost $600+/mo with no subsidy. She's chosen to pay the penalty.
Yeah the latimes...great publication to get your biased media reports from.
Part 2
If the feds are cooking the books, they've cooked them to look worse, not better -- the 36 states that dumped their enrollment responsibilities on the federal government are clustered at the bottom of the list, most of them with enrollment rates of 20% or less of eligible citizens. Many of these are states that actively discouraged or interfered with enrollments of their citizens in health insurance plans -- behavior that should be grounds for impeachment or recall of their governors and legislators.
Of course, even the enrollment of 7 million Americans in ACA exchanges doesn't mean Obamacare is a certified success. There's a lot of work to be done to fix the inevitable flaws in any law as far-reaching as this one. As Noam Levey reported, it amounts to the largest expansion of health coverage for Americans since the enactment of Medicare half a century ago, but many more people need to be signed up in coming years.
The apparent success of the first annual open enrollment period, however, should show Republican naysayers that this law is here to stay, with all its customer-protection provisions intact. It's time they recognized that the rhetoric about Obamacare's failure has gotten them nowhere. It's gotten the country nowhere. It's time for them to get behind the law, to help get their fellow citizens the coverage they need, and to help fix what needs to be fixed.
http://www.latimes.com/business/hiltzik/la-fi-mh-obamacare-numbers-20140331,0,3441389,full.story#axzz2xkvUZDzz
If the feds are cooking the books, they've cooked them to look worse, not better -- the 36 states that dumped their enrollment responsibilities on the federal government are clustered at the bottom of the list, most of them with enrollment rates of 20% or less of eligible citizens. Many of these are states that actively discouraged or interfered with enrollments of their citizens in health insurance plans -- behavior that should be grounds for impeachment or recall of their governors and legislators.
Of course, even the enrollment of 7 million Americans in ACA exchanges doesn't mean Obamacare is a certified success. There's a lot of work to be done to fix the inevitable flaws in any law as far-reaching as this one. As Noam Levey reported, it amounts to the largest expansion of health coverage for Americans since the enactment of Medicare half a century ago, but many more people need to be signed up in coming years.
The apparent success of the first annual open enrollment period, however, should show Republican naysayers that this law is here to stay, with all its customer-protection provisions intact. It's time they recognized that the rhetoric about Obamacare's failure has gotten them nowhere. It's gotten the country nowhere. It's time for them to get behind the law, to help get their fellow citizens the coverage they need, and to help fix what needs to be fixed.
http://www.latimes.com/business/hiltzik/la-fi-mh-obamacare-numbers-20140331,0,3441389,full.story#axzz2xkvUZDzz
The Rand Corporation...snicker snicker... ultra-militaristic piece of garbage.
Obamacare numbers coming in huge: Here's a guide to GOP excuse-making
By Michael Hiltzik
March 31, 2014, 10:36 a.m.
Against all odds and expectations, enrollments in health plans qualified under the Affordable Care Act are surging Monday toward -- and maybe beyond -- the 7-million figure projected by the Congressional Budget Office before Oct. 1, when the open-enrollment period began. The deadline for starting enrollment applications for 2014 plans is midnight Monday.
The surge is creating a big problem for the "train wreck" narrative of Republican opponents of the ACA, who have been holding out hope for Obamacare's utter failure. So the excuse-making has begun.
Before we examine those excuses: You will recall that the budget office reduced its projection of enrollments on individual insurance exchanges to 6 million earlier this year to account for the botched launch of healthcare.gov, the federal enrollment website. Enrollments blew past that mark days ago. If exchange enrollments meet or exceed the original projection of 7 million despite the loss of some six weeks in website functionality in October and November, that would be a testament to the public's latent desire for effective healthcare coverage.
Photos: The battle over the Affordable Care Act
We won't know the final March 31 tally for days, possibly weeks, but that indispensable enrollment tracker Charles Gaba is projecting 6.78 million exchange enrollments, with a chance of topping 7 million.
That figure covers enrollments in private healthcare plans via healthcare.gov and the individual websites offered by 14 states and the District of Columbia. As my colleague Noam Levey is reporting, the Rand Corp. estimates that another 4.5 million previously uninsured adults have signed up for Medicaid in states that expanded that program under the ACA. And about 3 million young adults have obtained coverage through an ACA provision allowing them to stay on their parents' employer plans until age 26.
For Obamacare critics, consequently, the enrollment numbers demand debunking. Here's a bestiary of their arguments for why the figures shouldn't be believed, and explanations of why they're off-base.
"How many have paid?" (Also known as "The statistics are full of deadbeats"): We examined this argument a few days ago. We observed that the concern is probably exaggerated and certainly premature, since many people who enrolled late in the cycle, including those in the March surge, may not have payments due for as much as six weeks after enrollment. Many haven't even received their first monthly premium bill yet.
Figures from states that track this metric, including California and Vermont, show that 85% to 90% of enrollees have paid on time, which secures them the coverage they applied for.
"Most of them were already insured": The argument here is that if we've just moved people from one insurance plan to another, we've just been wasting Americans' time and subjecting them to an onerous bureaucratic procedure as well.
The claim is based primarily on a survey in January from McKinsey and Co., which concluded that only 11% of exchange enrollees had been previously uninsured. A McKinsey survey a month later raised that figure to 27% -- still low, compared to expectations.
The major problem with the McKinsey survey is that doesn't say what its hawkers claim. The survey combines on-exchange enrollments and off-exchange enrollments; the latter are likely to heavily skew figures toward the previously insured because those are most likely people signing up again with their existing carriers. The goal of the exchange marketplaces, however, is to reach uninsured Americans. The McKinsey surveys don't break out on-exchange signups, but it's probably that the share of previously uninsureds in that group is higher than the combined total.
The few states that do break out their own numbers reinforce that expectation. Kentucky says that some 75% of its exchange enrollees were previously uninsured. New York says that about 60% of its exchange enrollees were previously uninsured. That number has been rising over time, raising the prospect that the March surge will include an even higher ratio of uninsured customers; Gaba, who has calculated a time series of New York enrollments based on the state's monthly news releases, calculates that of enrollees in mid-February, at least 92% had been uninsured.
"'Young invincibles' aren't signing up": This is related to the oft-mentioned threat of a "death spiral" in the insurance market -- if the enrollees are predominantly older and sicker consumers, they'll drive up premiums, which will discourage younger and healthier people from enrolling, which drives up premiums, which discourages, the young, etc., etc.
Federal officials have set an informal target of 40% of enrollments in the 18-34 age range. The latest figures from various states put the enrollment rate at the mid-20% level. But it was always expected that younger people would be among the last to enroll, and reports from the states suggest that's happening.
Even if the statistics remain fixed in the mid-20s, however, the death spiral won't be happening. The Kaiser Family Foundation estimated that even if the young enrolled at only 50% of expected levels, premiums for 2015 would have to be raised a couple of percentage points. That's nowhere near enough to set off a death spiral.
Moreover, as we explained way back in October, the ACA has a corrective to the death spiral written in. It's called risk adjustment, and it works by paying a subsidy to insurance companies that end up with older or sicker customer bases than they anticipated. The money comes from payments made by carriers that end up with favorable customer profiles. Republicans know this arrangement will keep Obamacare stable. How do we know? Because in a majestically cynical move spearheaded by Sen. Marco Rubio, R-Fla., they tried late last year to kill it, calling it an insurance "bailout."
"More people got cancellations than signed up": The numbers never supported this claim, and the latest estimates make it even more of a fantasy. It's based on the wave of reports late last year of insurance companies canceling old policies that didn't meet ACA standards, which led to hysterical claims that as many as 17 million Americans were being left uninsured.
Rand's figures support earlier estimates that fewer than 1 million people who had health plans in 2013 are now uninsured because of cancellations. Insurance companies that issued the cancellation notices say they've retained "the vast majority" of their old customers, mostly by moving them into new, compliant, plans.
"The White House is 'cooking the books'": This is the last refuge of scoundrels like Sen. John Barrasso, R-Wyo., who made the claim this weekend on Fox News Sunday while the slack-jawed host, Chris Wallace, sat silently by.
What makes this claim particularly fatuous is that the most encouraging figures don't come from the federal government at all, but from states with their own enrollment programs. The eight states with the best records of signing up their eligible citizens in exchange plans (actually seven states and D.C.), all have their own exchanges and websites. Vermont leads the parade at 83% enrolled. California, which leads all states in number of exchange enrollees at more than 1 million, ranks fourth with a 41% outreach rate.
Obamacare numbers coming in huge: Here's a guide to GOP excuse-making
By Michael Hiltzik
March 31, 2014, 10:36 a.m.
Against all odds and expectations, enrollments in health plans qualified under the Affordable Care Act are surging Monday toward -- and maybe beyond -- the 7-million figure projected by the Congressional Budget Office before Oct. 1, when the open-enrollment period began. The deadline for starting enrollment applications for 2014 plans is midnight Monday.
The surge is creating a big problem for the "train wreck" narrative of Republican opponents of the ACA, who have been holding out hope for Obamacare's utter failure. So the excuse-making has begun.
Before we examine those excuses: You will recall that the budget office reduced its projection of enrollments on individual insurance exchanges to 6 million earlier this year to account for the botched launch of healthcare.gov, the federal enrollment website. Enrollments blew past that mark days ago. If exchange enrollments meet or exceed the original projection of 7 million despite the loss of some six weeks in website functionality in October and November, that would be a testament to the public's latent desire for effective healthcare coverage.
Photos: The battle over the Affordable Care Act
We won't know the final March 31 tally for days, possibly weeks, but that indispensable enrollment tracker Charles Gaba is projecting 6.78 million exchange enrollments, with a chance of topping 7 million.
That figure covers enrollments in private healthcare plans via healthcare.gov and the individual websites offered by 14 states and the District of Columbia. As my colleague Noam Levey is reporting, the Rand Corp. estimates that another 4.5 million previously uninsured adults have signed up for Medicaid in states that expanded that program under the ACA. And about 3 million young adults have obtained coverage through an ACA provision allowing them to stay on their parents' employer plans until age 26.
For Obamacare critics, consequently, the enrollment numbers demand debunking. Here's a bestiary of their arguments for why the figures shouldn't be believed, and explanations of why they're off-base.
"How many have paid?" (Also known as "The statistics are full of deadbeats"): We examined this argument a few days ago. We observed that the concern is probably exaggerated and certainly premature, since many people who enrolled late in the cycle, including those in the March surge, may not have payments due for as much as six weeks after enrollment. Many haven't even received their first monthly premium bill yet.
Figures from states that track this metric, including California and Vermont, show that 85% to 90% of enrollees have paid on time, which secures them the coverage they applied for.
"Most of them were already insured": The argument here is that if we've just moved people from one insurance plan to another, we've just been wasting Americans' time and subjecting them to an onerous bureaucratic procedure as well.
The claim is based primarily on a survey in January from McKinsey and Co., which concluded that only 11% of exchange enrollees had been previously uninsured. A McKinsey survey a month later raised that figure to 27% -- still low, compared to expectations.
The major problem with the McKinsey survey is that doesn't say what its hawkers claim. The survey combines on-exchange enrollments and off-exchange enrollments; the latter are likely to heavily skew figures toward the previously insured because those are most likely people signing up again with their existing carriers. The goal of the exchange marketplaces, however, is to reach uninsured Americans. The McKinsey surveys don't break out on-exchange signups, but it's probably that the share of previously uninsureds in that group is higher than the combined total.
The few states that do break out their own numbers reinforce that expectation. Kentucky says that some 75% of its exchange enrollees were previously uninsured. New York says that about 60% of its exchange enrollees were previously uninsured. That number has been rising over time, raising the prospect that the March surge will include an even higher ratio of uninsured customers; Gaba, who has calculated a time series of New York enrollments based on the state's monthly news releases, calculates that of enrollees in mid-February, at least 92% had been uninsured.
"'Young invincibles' aren't signing up": This is related to the oft-mentioned threat of a "death spiral" in the insurance market -- if the enrollees are predominantly older and sicker consumers, they'll drive up premiums, which will discourage younger and healthier people from enrolling, which drives up premiums, which discourages, the young, etc., etc.
Federal officials have set an informal target of 40% of enrollments in the 18-34 age range. The latest figures from various states put the enrollment rate at the mid-20% level. But it was always expected that younger people would be among the last to enroll, and reports from the states suggest that's happening.
Even if the statistics remain fixed in the mid-20s, however, the death spiral won't be happening. The Kaiser Family Foundation estimated that even if the young enrolled at only 50% of expected levels, premiums for 2015 would have to be raised a couple of percentage points. That's nowhere near enough to set off a death spiral.
Moreover, as we explained way back in October, the ACA has a corrective to the death spiral written in. It's called risk adjustment, and it works by paying a subsidy to insurance companies that end up with older or sicker customer bases than they anticipated. The money comes from payments made by carriers that end up with favorable customer profiles. Republicans know this arrangement will keep Obamacare stable. How do we know? Because in a majestically cynical move spearheaded by Sen. Marco Rubio, R-Fla., they tried late last year to kill it, calling it an insurance "bailout."
"More people got cancellations than signed up": The numbers never supported this claim, and the latest estimates make it even more of a fantasy. It's based on the wave of reports late last year of insurance companies canceling old policies that didn't meet ACA standards, which led to hysterical claims that as many as 17 million Americans were being left uninsured.
Rand's figures support earlier estimates that fewer than 1 million people who had health plans in 2013 are now uninsured because of cancellations. Insurance companies that issued the cancellation notices say they've retained "the vast majority" of their old customers, mostly by moving them into new, compliant, plans.
"The White House is 'cooking the books'": This is the last refuge of scoundrels like Sen. John Barrasso, R-Wyo., who made the claim this weekend on Fox News Sunday while the slack-jawed host, Chris Wallace, sat silently by.
What makes this claim particularly fatuous is that the most encouraging figures don't come from the federal government at all, but from states with their own enrollment programs. The eight states with the best records of signing up their eligible citizens in exchange plans (actually seven states and D.C.), all have their own exchanges and websites. Vermont leads the parade at 83% enrolled. California, which leads all states in number of exchange enrollees at more than 1 million, ranks fourth with a 41% outreach rate.
Numbers from a RAND Corporation study that has been kept under wraps suggest that barely 858,000 previously uninsured Americans – nowhere near 7.1 million – have paid for new policies and joined the ranks of the insured by Monday night.
Read more: http://www.dailymail.co.uk/news/article-2594309/President-plans-victory-lap-strong-Obamacare-enrollment-Sebelius-faces-unpopular-law-blank-stare-tough-questions-remain-whos-signing-up.html#ixzz2xkinYHQb
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Read more: http://www.dailymail.co.uk/news/article-2594309/President-plans-victory-lap-strong-Obamacare-enrollment-Sebelius-faces-unpopular-law-blank-stare-tough-questions-remain-whos-signing-up.html#ixzz2xkinYHQb
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I understand that its anecdotal, but I believe Barb mentioned a friend who recently became insured through the program. Basically the policy says if she uses it, she loses it.... back to the drawing board if that's the case.
We can do better.
We can do better.
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