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 matters. At 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.