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Wrong Target
Easy Come, Easy Go

In case you missed it, the latest bad news for the Affordable Care Act came via the New York Times this past weekend: Americans who signed up for coverage through the law are dropping their insurance at least in part because the plans are too expensive.

About 9.9 million people were enrolled in the federal and state marketplaces at the end of June, a drop of about 15 percent from the 11.7 million who the Obama administration said selected plans during the open enrollment period that ended in February.

Though there is no comprehensive data on why people drop or lose their marketplace coverage, enrollment counselors, health care providers and consumers say cost is a factor. In some cases, people lost jobs or their income dropped after they enrolled. Other people signed up for coverage only to decide later that they could not afford it. Still others dropped their insurance after their federal subsidies — intended to help pay premiums — were reduced or eliminated because the government could not verify their incomes or concluded that they were earning more than they had reported on their applications.

If only someone had predicted that the initial sign-up numbers celebrated by ACA employees might drop because of retention problems:

One point we’ve emphasized about this enrollment number is that it doesn’t tell us how many of those signing up were previously uninsured. The law was supposed to expand access to the previously uninsured, not kick people off their current plans and on to the exchanges. And there’s another way this announcement could be misleading. We don’t know how many of those seven million will pay their premiums. If Americans sign up now only to miss payments later, the initial enrollment figures will wind up telling us little about how successful Obamacare has been.

Parts of Obamacare, like its attempt to loosen the tight link between employment and insurance, are good, and Americans do not simply want to return to the pre-ACA reality. But the law is also nowhere near as successful as some of its supporters claim. Before the ACA, health care was too expensive for many Americans individually and for the nation as a whole. The ACA has not changed that fundamental reality, and this attrition is just one sign of that. America needs health care reform that brings down costs—we’ve suggested some policies toward that end many times—and until we get it, coverage numbers are not likely to prove very stable.

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