As we inch toward the March 31 enrollment “deadline,” I think it is fair to ask, “Is Obamacare working?” And by working, I mean both politically for the Democrats and substantively for the country. White House senior official Dan Pfeiffer tweeted out, “Important to remember that back in Oct and November, everyone thought getting to 6 mil was impossible. Amazing comeback story.” We can discount that; Team Obama’s credibility is shot. So what do we really know? What does the information available really tell us, and what can we discern from the constant evasiveness of the administration?
Substantively, the administration is refusing to acknowledge a few essential points. One, the original definition of “success” — the CBO number they adopted as their own — was 7 million enrollees. And next, an estimated 20 percent of the alleged 6 million enrollees have not paid their premiums, which means they do not actually have insurance. That leaves us with 4.8 million enrollees at best, without discounting duplicate enrollments, unfinished applications and any other factors that would diminish the number who have actually signed up for Obamacare.
HHS Secretary Kathleen Sebelius continues to stonewall Congress and to claim that HHS does not know how many people have paid their premiums. In response, House Ways and Means Committee Chairman Dave Camp (R-Mich.) and Ways and Means Health Subcommittee Chairman Kevin Brady (R-Tex.) wrote her a letter saying, “We have recently obtained information that suggests your most recent testimony before the Ways and Means Committee was at best evasive and perhaps misleading.” (Camp and Brady are such gentlemen.) The letter continued, “Insurers are submitting information to CMS about who has effectuated their enrollment, i.e. who has paid their premium. Please provide this information in its most updated form immediately.” In other words, the administration has the data but doesn’t want to release it because it would derail their narrative that Obamacare has reached a point where something meaningful has happened.
But, oh, by the way, the most stunning omission from the White House, Sebelius, et. al. is that Obamacare has failed miserably in its original purpose — insuring the uninsured. President Obama and his Democratic allies can claim that 6 million people have gotten insurance, but we still don’t know how many of those are newly insured.
Regardless of the number of enrollees, or the number of people who are receiving subsidies, or how many people are able to keep their doctor, the bottom line is that Obamacare’s success should be based on the number of people who have insurance today who were uninsured before Obamacare was passed. Of course, that’s not something the administration will even admit they are tracking. What does that tell you? After all the insurance cancellations, the administration’s insistence that 6 million people now have insurance because of Obamacare is a lot like firing 20 people, hiring 18 of them back and claiming that you have created 18 new jobs. In other words, nobody knows what the net number of people insured is once you have factored in how many people lost their insurance because of Obamacare.
But all of this is just the appetizer. The political entrée is how voters will react to the quality of care, access and premiums/co-pays they will encounter in the Obamacare exchanges over the next year. Maybe the Web site works better, and maybe some newly insured individuals have signed up. The real test will be if Obamacare can deliver insurance with a health-care plan that people actually like by November. That’s a lot harder than fixing a Web site or fudging enrollment numbers.
From an insurer standpoint, an enrollment mix where only 25 percent are in the golden 18-34 age bracket is not the definition of “success.” And if the enrollees lean toward older, sicker people, premiums are going to go up dramatically for everyone. The premiums will be higher, and the only way insurers can lower prices is to make their networks more and more restricted, limiting access and choice for millions of Americans. That’s not what success looks like.
Vulnerable Democrats on the ballot in 2014 know this. They are going to spend the next seven months offering “fixes” for the unpopular parts of Obamacare – as we started to see yesterday – and will try to escape blame for the continuing failures. We can already hear the “there is more work to do” pablum they will be spewing.
The champions of Obamacare — who are quickly diminishing in number — say it is here to stay, that it is the law of the land and millions are counting on it. They celebrate the idea that the infection that is Obamacare has crept into the population and will never be undone. This all overlooks how much of the law has been changed, delayed, overturned, or otherwise diluted by lawmakers who struggle with all of Obamacare’s failures. The more we find out about Obamacare, the less chance there is that Obama and his Democratic allies will be able to claim success and convince voters they are better off with it than without it.
Is Obamacare working? The short answer is no.
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