mead cohen berger shevtsova garfinkle michta grygiel blankenhorn
ACA Amnesia
A Wary Obama Lowballs Obamacare

The second round of open enrollment on the exchanges created by the Affordable Care Act begins this Saturday, and the Obama Administration has released a scaled-back estimate of the number of people who are expected to sign up. The CBO previously estimated that 13 million Americas would enroll by next year, out of the 46 million uninsured Americans that the Administration claims existed prior to the ACA. In the new announcement, that number has been reduced from 13 million to 9 million. More, via the NYT:

The new estimate appeared to be part of an effort by federal officials to lower public expectations, so the goal would be easier to meet and to surpass. In addition, the new number could indicate that administration officials believe it will be difficult to find and enroll many of the uninsured while retaining those who signed up in the last year. […]

President Obama announced in April that eight million people had signed up for health insurance under the Affordable Care Act. Officials said Monday that enrollment had declined to 7.1 million after some people failed to pay their share of premiums and others were found to be ineligible because of unresolved questions about their citizenship or immigration status.

These revised estimates are neither the total disaster predicted by Republicans nor the success predicted by Democrats. What we are seeing is a welcome but slight expansion of the number of insured Americans, but one that is turning out to be even slighter as people who initially signed up drop out. In light of that, the Administration seems finally to be realizing that is better to surpass a low estimate than fail to meet a high one, and is consequently lowering the expectations it sets.

This is smart politically—and the new realism is refreshing—but it also shows that the law is not living up to the promises made at its passage. Those promises helped ensure its passage in the first place, but they are now being revised down. Nine million might not seem like much less than thirteen million—even when you consider that the nine million will shrink through attrition. But supporters of the ACA have recently taken to using individual anecdotes of Americans who will die if the Supreme Court strikes down federal subsidies in King v. Burwell. The ACA’s supporters have always insisted that every individual uninsured person mattersAt the very least, it would be hypocritical for them to shrug when 4 million fewer individuals than once predicted get health insurance.

Recently several pundits have declared the ACA a success, with the NYT’s stating “the Affordable Care Act has largely succeeded in delivering on President Obama’s main promises.” These new estimates that promise less than before demonstrate that the Administration doesn’t agree—and it is right.

Features Icon
show comments
  • Andrew Allison

    Can we please stop pretending that the 7.1 million currently enrolled and 9 million hoped for next year were previously uninsured. How many of them lost their existing coverage thanks to ACA? The number of previously uninsured now insured is significantly less than advertized. The enormous expense to taxpayers and those ineligible for subsidies has resulted in, what, a 10% reduction in the number of uninsured? It would have been cheaper just to pay their premiums (which we’re doing anyway.

    • FriendlyGoat

      You’re making a pretty good argument for single-payer.

      • Andrew Allison

        If you’d been following my comments on this topic, you’d know that it’s my belief that IF we want to provide universal health insurance, single-payer (Medicare for all) is the only feasible way to do so. Note the emphasis on insurance. Thanks to the medical lobby and the VA, there’s not the slightest possibility of single provider health care delivery in the USA. That means that the fraud problems alluded to in the original post would also become universal. At the risk of being repetitious, the only way to deal with this is to come down like a ton of bricks on abusers. The driving license points system provides a good model: three strikes and you’re struck off (that’s English for losing your licence to practice).

        • FriendlyGoat

          Like I said, you’re making a pretty good argument for single-payer. The first key to coming down on abusive providers like a ton of bricks is having a reimbursement system no one can afford to opt out of. The “license to practice” thing is problematic because we don’t do that on a national level. But we could have a national “license to get paid”.

          • Andrew Allison

            As usual, your so-called “progressive” blinders lead you astray. The “IF’ relates to the fact that it’s far from clear that the majority of the country (did you miss the results of the recent election?), as opposed to progressives, actually does want universal insurance. As the topic of this thread demonstrates, there’s no such thing as a reimbursement system that nobody can opt out of. What part of Whack-a-Mole don’t you grasp. You are equally confused about the license to practice issue. It’s true that licenses are issued by the States. It’s also true that the Feds control Medicare/Medicaid reimbursements. In case it’s not clear, if the Feds say pull these licenses of lose Federal funding, the licenses will be pulled.

          • FriendlyGoat

            There are exactly zero people who would not wish for themselves or their loved ones to be covered for health expenditures, with the relatively small exception of people wealthy enough to feel comfortable with complete self insurance. MANY of the people who swung the election (37% turnout, heavily weighted to elderly) are actually on Medicare, ironically enough. Many others are lulled to sleep by their histories on employers’ plans, a trend that is going out—not coming in. This election was not a referendum on a single-payer plan, It was, as usual of late, a product of the right-wing misinformation machine in high gear.

            You don’t have the Feds pulling the medical licenses of abusive providers. Perhaps your incoming GOP majority will get that done, eh? More likely your guys will be on their side to assure they face no regulation at all.

          • Boritz

            “The idea of keeping corporations from making too much off of government is NOT their core platform, you know.”

            That is in neither major party’s platform.

            Arthur Jensen to Howard Beale:
            “There are no Russians. There are no Arabs. There are no third worlds. There is no West. There is only one holistic system of systems, one vast and immane, interwoven, interacting, multivariate, multinational dominion of dollars…There is no America. There is no democracy. There is only IBM, and ITT, and AT&T, and DuPont, Dow, Union Carbide, and Exxon. Those are the nations of the world today.”

            The Left is fine with this as long as the “immane, interwoven, interacting” relationship between business and government is fully controlled by them. Then there will be no such thing as “making too much” or taking too much for that matter.

          • FriendlyGoat

            There is an “inconvenient truth” (no, not Al Gore or AGW) that leftist politicians have to raise enough money to compete with rightist politicians in the media battles of elections. Dems simply cannot offend the business community “too much” and have enough financial wherewithal to be relevant at all. I’m not one who will blame them all as “complicit capitulating bums” because such a stance does not reconcile with political reality. So, I’ll have to decline your invitation to do that.

© The American Interest LLC 2005-2016 About Us Masthead Submissions Advertise Customer Service