The American Interest
Analysis by Walter Russell Mead & Staff
ACA Revisionism Obamacare: What Was the Point, Exactly?

Before the ACA enrollment surge, McKinsey & Co estimated that 11 percent of enrollees in the individual market were previously uninsured. Now McKinsey has a new estimate indicating that the surge brought that number up, but not by much:

Of all respondents who reported selecting a new qualified health plan (QHP) at the time of the April survey (either on or off the exchanges), 26% reported being previously uninsured. 87% who selected a new 2014 QHP indicated that they had already paid their first premium. Reported payment rates were higher among those previously insured and those aged 30 or older.

The McKinsey survey measures both individuals purchasing directly through insurance companies and those purchasing through the Obamacare exchanges. Since this number isn’t targeted directly at the exchanges, we still don’t have a complete understanding of how many of the eight million new exchange enrollees were previously uninsured. But we can still say that overall, the ACA push for people to sign up for insurance has included many who were previously insured. Here Robert Laszewski estimates that restricting the scope to just the exchanges yields a 50/50 split: half were previously uninsured, half weren’t.

Judging by these numbers, we’re looking at somewhere between two million and four million enrollees who didn’t already have insurance. But this is nowhere near the law’s original goal and a far cry from the 14 million uninsured Americans that the CBO originally predicted would receive coverage during the ACA’s first year of open enrollment. Once again, we see that the victory lap over Obamacare was highly premature. We don’t yet know for certain how many previously uninsured gained coverage, but we do know it is less than the Left has been promising all along.

Published on May 9, 2014 5:15 pm
  • gvanderleun

    We all realize that the “number” and the “numbers” are bogus and exaggerated to begin with. Right? Right. So why do even the fair, balanced, and somewhat smart of our commentators such as “Mead and Staff” use them for a baseline? How does pretending the lies are true help anything?

    • gvanderleun

      I mean, what’s the point of that, exactly?

  • lukelea

    Not sure whether this if off topic or not, but I can say this in favor of the federal government’s web site healthcare.gov: as someone on Medicare using the Medicare drug prescription plan (Medicare Part D) it navigated me through the jungle of alternative options and plans to find the cheapest one in my area, given the drugs I am currently taking. This would be virtually impossible on one’s own. The only down side is that I had no idea this ap (I guess it is an ap) existed and stumbled upon it by accident. Here is the page that gave me the link:

    http://www.seniorark.com/medicare/D.htm

    Federal exchanges as Mickey Kaus has pointed out are nothing more than web pages that help you find the best deals out there. If this is how they work then all power to them.

  • lukelea

    For some reason the Disqus comment platform is not working with my browser (Opera). This is something new.

  • Jim__L

    The point was to be more Eurosocialist, in an era where Eurosocialism is destroying Europe’s ability to defend itself.

  • ICBS_PAC

    Also, don’t forget many of those who previously had insurance were paying a lot more money for a lot less coverage. Obamacare is working pretty much as expected. I have so much respect for WRM’s opinions of other topics (energy policy, for instance), it is baffling why he is such a hack on Obamacare. It is a huge blow to his credibility.

    • rheddles

      many of those who previously had insurance were paying a lot more money for a lot less coverage.

      And now I’m paying a lot more for their increased coverage. No thanks.

      • ICBS_PAC

        You realize that Obamacare is still a deficit reduction measure, correct? Unless you are personally buying medical equipment or a high income person using a bare-bones catastrophic, you are not paying a lot more for their coverage, you’re just a grinch.

  • Ken Kelly

    If you are going to make statistical claims, you should learn statistics. McKinsey did not conclude that only 26% of individual market QHP purchasers were “previously uninsured”. Nor did they offer any evidence for such a conclusion. To do so, one would have to draw a random sample from the population of QHP buyers, and then count the number of previously uninsured in that sample. McKinsey did not do that. Rather they drew several samples from different populations and then aggregated the results. You can’t extrapolate to any population if you do this – you can only look for trends, comparing results to previous, identically constructed studies. Which is what McKinsey did:

    “These findings are directional indicators only, based on publicly reported enrollment data and our own national online consumer survey.”

    Other surveys have attempted to estimate the change in the uninsured population since the exchanges and expanded medicaid began last fall. Most recently, Gallup estimated that the number of uninsured adults had dropped by over 11 million by early April. An earlier Gallup survey asked self-reported newly insured people where they got their insurance – more than half specified the exchanges. These numbers – and every other I’ve seen (the RAND survey excepted) – support the same conclusion: that the CBO prediction of a net drop in uninsured of about 6 million from the exchanges alone will prove reasonably accurate.

    http://www.gallup.com/poll/168821/uninsured-rate-drops.aspx
    http://www.gallup.com/poll/168548/newly-insured-2014-represent-adults.aspx
    http://www.cbo.gov/publication/45231