Total numbers that include both insured and uninsured aren’t nearly as useful as breakdowns that separate these two groups. And these numbers are much less encouraging. True, 76 percent of all insured ages 18-64 say that “insurance is something I need.” But 40 percent don’t think health care is worth its price, and that number should be extremely troubling to ACA advocates. Since many of the currently insured will keep their current employer-based plan, the fate of the exchanges really hangs on the decisions of the uninsured. Unless a high percentage of currently uninsured youth opt in, Obamacare will face severe, possibly fatal, problems.Of course, that 40 percent won’t necessarily translate into 40 percent refusal to comply with the mandate. People do occasionally buy things they consider bad deals if they have no other choice, and health care is the paradigm case of having no other choice. But there’s one serious wrinkle: people still don’t know what the price will be. If it’s higher than they expect and more expensive than their depressed wages will afford them, that 40 percent could grow very quickly. And if the rate shock is anywhere near as high as some health care experts predict, that number could start translating rapidly into youth non-participation.ACA supporters know this, which is why they’re hoping to bring in some star power. Politico reports that Enroll America leaders are reaching out to the NBA basketball stars, asking them to help promote Obamacare.It’s unclear whether, even with this star power, the Enroll America campaign will be able to paper over the structural flaws of the law. But there’s an even more basic problem: low participation rate of the youth in the exchanges won’t matter if the exchanges don’t get set up in the first place, and a recent report suggests they’re having some trouble. The GAO has just issued the first systematic, independent look at the progress of the rollout, and it found that administration officials had so far missed several deadlines in the creation of exchanges, and that the fate of the law was uncertain. WSJ:
“Whether [the government’s] contingency planning will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined,” said the GAO in twin reports to be released Wednesday.
This isn’t a ringing denunciation, but it’s enough to sound the warning bells. More importantly, it shows just how much—even three years after the law was passed—we still have no idea how it will work or what its effects will be.