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ACA Revisionism
Getting the Facts Right on the ACA

Another day, another ACA distortion. USA Today has done a good job fact-checking President Obama’s claim that the recently announced enrollment figures are a sign the “Affordable Care Act is working ‘a little bit better than we anticipated.'” It all comes down to what metric you use—and as usual the goalposts have shifted to make space for this kind of claim:

The 11.4 million figure is better than the projection released by the administration in November, just before the enrollment period began. Then, HHS told reporters that it anticipated between 10.3 million and 11.2 million would sign up or re-enroll by the end of the open enrollment period. By that measure, the estimated 11.4 million who did sign up is “a little bit better” than anticipated.

But an HHS analysis said the department expected the figure would decline by the year’s end, as some wouldn’t pay premiums or would take other health insurance. The analysis estimated that between 9 million and 9.9 million would be the total for 2015′s marketplace enrollment. That’s 3 million to 4 million fewer Americans than the nonpartisan Congressional Budget Office’s estimate at the time: 13 million on marketplace, or exchange, plans this year.

So, the 11.4 million figure is a little bit worse than the CBO anticipated. CBO’s 13 million estimate is from April 2014; the most recent report, from January, estimates that 12 million would be on marketplace plans this year.

These numbers look even smaller, possibly as low as 5. 4 million, when you factor in estimates about how many of the people in the exchanges were in fact previously insured—as Avik Roy did recently and we covered here. The Administration has relied on this kind of goal-shifting from the beginning. When California’s first premiums were announced officials crowed that the rates were “lower than expected”—even though they were higher than existing plans. In this case, they are claiming to do better in enrollment than expected—even though they are doing worse than the CBO predicted and and even more worse than the original benchmarks at the time the law was passed. Apparently, misleading rhetorical tactics die hard.

Supporters of the law might argue that quibbling over 9 million versus 11 million is besides the point, but it should be noted that in the past some of them have made much of anecdotes about individual people who would be denied coverage under a conservative plan or without the ACA. Well, two million fewer is a lot of anecdotes. The truth is that the 5 million to 9 million range is not in line with initial estimates, not that sweepingly impressive, and not a good indicator of ACA success.

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  • lord acton

    The goal isn’t coverage, it is control and graft. Once you understand that, everything else makes sense.

    • FriendlyGoat

      Control and graft is what you had with medical underwriting.

      • lord acton

        Whatever gets you through the night FG. You are the truest of believers. Touching in a way. Happy trails.

        • FriendlyGoat

          If I COULD believe the conservatives’ spin on all the issues, I would. But I can’t, so I don’t. I’m glad you’re touched by my loyalty to the left, even if it has been hard for you to be touched by such things as half or more of the people in the country being at risk of immediate medical bankruptcy EXCEPT for the work of leftists.

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