“The verdict is in: Obamacare lowers uninsured,” says a headline on Politico.
“Obamacare haters, your case just got weaker,” writes The New Republic.
Sorry to be a buzzkill, but the celebration is a little premature. Coverage has increased, but 20 million? That’s a clear overstatement. The actual gains are nowhere near that high.
Had Obamacare cheerleaders more closely scrutinized the Commonwealth Fund’s report, they might not have been so quick to reach for the pompoms.
The foundation arrived at its headline figure by adding together the following groups: the 8 million consumers who selected an ACA marketplace plan; the 6 million who enrolled in Medicaid or the Children’s Health Insurance Program; the 5 million who purchased a plan directly from an insurer; and the 1 million young adults who gained coverage under a parent’s policy.
The first problem is the report counts all people obtaining health care coverage, regardless of whether they previously had it. That’s not “gaining” coverage — that’s replacing one form of coverage for another. Next, the 8 million people the Obama administration claims signed up for private coverage through the law’s health exchanges includes those who signed up but never paid. It also ignores the number of people who will likely fall out because of nonpayment, but the report can’t necessarily be faulted for that.
As for the Medicaid enrollees, the 6 million figure is technically accurate. But it’s a stretch to claim those numbers as an ACA victory because many were already eligible for Medicaid. They just never signed up until after October. Only someone looking for reasons to pad the numbers would make such a leap.
There’s the 5 million who purchased coverage outside the exchange. They include people who bought plans directly from brokers or insurance companies. Though these plans are ACA-compliant, they may not qualify for Obamacare subsidies. So how exactly can one claim these people are “gaining” cover under Obamacare?
As for the estimated 1 million people younger than 26 who now are dependents on their parents’ plans, some analysts believe the figure is vastly inflated. But even if it was dead-on accurate, Commonwealth’s 20 million figure is still likely off by millions. So pardon us for holding off on ordering party favors until more accurate figures come in.
The true test of whether Obamacare is “working” will be when the exchanges reach a stability point. For the exchanges to work, people — particularly the young and healthy — must enroll and stay enrolled to subsidize health care costs of older people. If too many drop out, premiums will rise to the point where the exchanges collapse. That’s always been the inherent weakness of the Obamacare individual mandate, which is a forced regressive tax on young and healthy Americans to purchase health insurance plans they can’t afford or don’t want so older and wealthier Americans can pay less.
If the law is allowed to stand as-is, many Americans will jettison Obamacare once they discover its inherent flaws make free-riding safer than ever, causing a downward spiral of falling enrollments and rising premiums that ends with the collapse of the entire system.
But if the left wants to declare victory after Obamacare’s first enrollment period and throw a party based on inflated numbers, hey, have a ball.
There may not be too many more reasons to celebrate in the future.