Wonkbook: What we know from Obamacare’s first open enrollment period

May 2

Welcome to Wonkbook, Wonkblog’s morning policy news primer by Puneet Kollipara. To subscribe by e-mail, click here. Send comments, criticism or ideas to Wonkbook at Washpost dot com. To read more by the Wonkblog team, click here.


(Photo by Karen Bleier/AFP/Getty Images)

Wonkbook’s Number of the Day: 12.8 million. That's how many people signed up for health insurance via the Obamacare exchanges or Medicaid during open enrollment.

Wonkbook’s Chart of the Day: This chart shows how reports of sexual assaults steadily have risen, before shooting up last year.

Wonkbook's Top 5 Stories: (1) The final Obamacare report in the first enrollment period; (2) how Big Data threatens privacy; (3) it's jobs day; (4) the local minimum-wage push; and (5) two areas of sexual assault crackdown.

1. Top story: What we learned from the final report on the first Obamacare enrollment period

States that didn’t set up marketplaces see surge in health plan enrollment, figures show. "A last-minute deluge of health insurance sign-ups came from states where political leaders have opposed the Obama administration’s health-care law, according to federal figures released Thursday. In March and April, the number of people enrolling in plans more than doubled in the 36 states that chose not to set up their own marketplaces....Most of these states deferred to the federal marketplace, HealthCare.gov....In Texas and Florida, which have fiercely resisted the Affordable Care Act, nearly 1 million people enrolled between March 1 and April 19. Similar increases took place in Georgia and North Carolina." Sandhya Somashekhar and Dan Keating in The Washington Post.

Primary source: The full text of the report.

Chart: How we got to 8 million signups in state and federal insurance marketplaces, with a state-by-state breakdown of enrollments. The New York Times.

Explainers:

Where Obamacare is strongest and where it's falling short. Sam Baker and Sophie Novack in National Journal.

4 things we learned from the report. Jonathan Cohn in The New Republic.

A major factor fueling the enrollment rush: Youth. "The 11th-hour scramble for coverage netted 3.8 million new enrollees nationwide in March and April, including nearly 1.2 million young adults ages 18 to 34, who accounted for 31 percent of the final enrollment surge. In the last seven weeks, these young adults more than doubled their national enrollment totals from the previous five months. Overall, the coveted young adult population accounted for 28 percent of state and federal marketplace signups. That’s short of the 40 percent level the Obama administration originally sought, but it is likely strong enough to prevent a 'death spiral.'" Tony Pugh in McClatchy Newspapers.

How many exchange enrollees previously lacked insurance? "The White House helped get us closer to an answer with its latest enrollment update....Only people applying for subsidies — about 95 percent of those who sought coverage on the federal healthcare.gov marketplace — were asked to report whether they has already had insurance. Of the nearly 5.2 million people who applied for financial help, only about 13 percent had health coverage; 4.5 million had been uninsured before Obamacare. Officials cautioned that the 13 percent figure for those with previous health coverage is unreliable." John Tozzi in Bloomberg Businessweek.

But exchange enrollment seems to be lagging among Latinos. "Hispanics, a key demographic for the Affordable Care Act, did not appear to sign up for health insurance through the law's marketplaces at the rate the Obama administration had hoped....The administration cautioned, however, that it did not have ethnicity data for about 31 percent of people selecting coverage on the federal marketplaces. The report also didn't include data from the 15 state-run exchanges, and it doesn't account for people who may have obtained coverage through Medicaid." Jason Millman and Sandhya Somashekhar in The Washington Post.

Why the fumble with Latino enrollment? "In part, it's because the administration fumbled. It delayed the launch of CuidadoDeSalud.gov — the Spanish-language enrollment website — until December, when it 'soft launched' so that Latino groups working with the administration could test and report bugs. Then when the administration did promote the website, users reported that the Spanish was a messy translation....More importantly, the administration delayed its outreach to the Latino population." Clara Ritger in National Journal.

Don't forget non-exchange enrollees, who could help stabilize risk pool. "Just over 8 million Americans signed up for private coverage in state and federal insurance marketplaces....Outside the marketplaces, the report said, an additional 5 million people bought [Obamacare-compliant] plans....Both sets of health plans sold within any given state belong to the same risk pool — the mix of policyholders ranging from young, healthy people to the old and sick....'We believe, based on the data that we've seen and independent data that's out there, that premiums will be stable and that the risk pool is sufficiently large and varied to support that kind of pricing in every state,' said Mike Hash, a top healthcare reform official." David Morgan in Reuters.

Insurers are definitely not pushing the panic button. "If the health-care law fell flat, health insurance companies would likely be the first to panic. Their whole business model, after all, relies on selling health policies. But right now they seem pretty calm: Obamacare is largely meeting expectations, two major insurance companies reported in the latest round of earnings calls." German Lopez in Vox.

Corporations may gradually push employees to exchanges, saving billions. "According to a report by S&P Capital IQ released Thursday, S&P 500 companies will likely move their employees from employer-provided health insurance plans to the healthcare exchanges under the Affordable Care Act, saving employers nearly $700 billion through the year 2025. If current healthcare inflation stays constant, those savings could be greater than $800 billion, researchers found." Ferdous Al-Faruque in The Hill.

Republicans' next plan of attack: The Burwell hearings. "Republicans are relishing the chance to use confirmation hearings for Sylvia Mathews Burwell, President Barack Obama's nominee as U.S. health secretary, to re-energize their election-year attacks on his signature healthcare initiative. Republicans, who are seeking to take control of the Senate in the Nov. 4 congressional elections, view a pair of Senate hearings for Burwell as their best chance to put a spotlight on Obamacare since the program's botched rollout in October....'One gaffe and they lose the news cycle,' a Republican Party strategist said." David Morgan in Reuters.

Poll: Obamacare's approval ratings steady despite enrollment surge. Louise Radnofsky in The Wall Street Journal.

Other health care reads:

U.S. city health officials want tighter restrictions on e-cigarettes. Reuters.

House GOP's anti-Obamacare message doesn't always come through members' websites. Sabrina Siddiqui and Sam Stein in The Huffington Post.

FLAVELLE: The least promising anti-Obamacare campaign. "A conservative group is trying a new tactic to gum up the works on Obamacare: publicly shaming insurance companies into refusing federal money that's designed to keep premiums affordable. If this is what the law's opponents have been reduced to, the Affordable Care Act is going to be just fine." Christopher Flavelle in Bloomberg View.

E. KLEIN: Americans believe two things about Obamacare enrollment that can’t both be true. "The most recent Kaiser Family Foundation tracking poll had some good news and some bad news for Obamacare. The good news was that a plurality of Americans know the law signed up 8 million people. The bad news is that a majority of Americans nevertheless think the law fell way short of expectations on enrollment. That's...weird." Ezra Klein in Vox.

BRENNAN: Obamacare was always going to drive up health spending. "While the Affordable Care Act doesn’t appear to have covered nearly as many previously uninsured people as it was supposed to, it’s covered some new people, and it’s forced millions more to buy more-comprehensive insurance plans than they used to have....The more ridiculous sycophants are trying to suggest this isn’t just a good thing because people are getting care, it’s good because that jump in health-care economic activity pushed first quarter GDP growth into positive territory. This is nonsense." Patrick Brennan in National Review.

Top opinion

CASSIDY: The Piketty bubble is more than just hot air. "Evidently, we are reaching what Shrimsley...calls stage three: 'backlash,' in which critics question Piketty’s credibility and some people write off the whole thing as media hype....But as with all bubbles and fads, it is important to distinguish between the social meta-phenomenon and the underlying object of discussion. In this case, that is Piketty’s analysis of contemporary capitalism, which, despite numerous critiques — from the left as well as the right — stands on its own merits....'Capital In the Twenty-first Century' is proving so successful because it illuminates one of the great issues of our time, rising inequality, and provides a simple but novel explanation for it." John Cassidy in The New Yorker.

KRUGMAN: Why economics failed us. "I don’t mean that economics was useless to policy makers. On the contrary, the discipline has had a lot to offer. While it’s true that few economists saw the crisis coming — mainly, I’d argue, because few realized how fragile our deregulated financial system had become, and how vulnerable debt-burdened families were to a plunge in housing prices — the clean little secret of recent years is that, since the fall of Lehman Brothers, basic textbook macroeconomics has performed very well. But policy makers and politicians have ignored both the textbooks and the lessons of history. And the result has been a vast economic and human catastrophe." Paul Krugman in The New York Times.

FRUM: How immigration reform could boost poverty. "Over the past two decades, the United States has run an immigration policy that has substantially increased poverty....Even long-established immigrants are disproportionately likely to stay poor. Among immigrants (of all origins) who have resided in the United States for longer than 20 years, the poverty rate is 30 percent higher than among the native born (of all races)....As the United States debates an immigration reform that will substantially increase the flow of unskilled immigrants, Americans need to keep in mind that the debate over how much immigration to welcome is also a debate about how much more poverty to accept." David Frum in The Atlantic.

RAMPELL: Millennials at odds with America. "We already knew that millennials don’t trust people in general. Now we also know how little they trust people (and institutions) in particular. Perhaps with good reason....A new survey from Harvard’s Institute of Politics now finds that whatever faith young people may have had in specific U.S. institutions and authority figures is also rapidly crumbling....Basically it’s disaffection and distrust all around. Apparently, we millennials don’t even trust Jay-Z anymore. Why are young people so cynical about our leadership, institutions and compatriots?" Catherine Rampell in The Washington Post.

WORSTALL: Where Kristof erred on regulations. "Nick Kristof is entirely right in part of his argument in the New York Times today: sometimes regulations do save lives without killing jobs. However, that’s not the end of the argument. Some regulations do kill jobs, prevent economic growth, to a far greater level than they do in the lives they save. And we’ve a way of wo0rking out which is which too, the statistical value of a life. Using this tool we can see that stating that all regulation is good is just as bad as saying that all regulation is bad." Tim Worstall in Forbes.

Animals interlude: Watch this lamb learn how to walk.

2. How Big Data threatens privacy, and how the White House wants to address it

U.S. study finds benefits, risks of mass data collection. "A new White House report on mass collection of data concludes it is 'saving lives' but calls for more privacy safeguards to secure personal information from being leaked, shared without permission or used to discriminate....President Obama called for the assessment of 'big data' in January, amid pressure over revelations about U.S. spy agencies gathering data on phone records. The administration's review, however, did not focus on data collected for intelligence, but looked at how other government agencies, the private sector and educational institutions use the almost boundless information available about U.S. consumers." Kathleen Hennessey and Robert Faturechi in the Los Angeles Times.

What does the report recommend? "They include passing a national data breach law that would require companies to report major losses of personal and credit card data, after attacks like the one on Target that exposed credit card information on roughly 70 million customers. It seeks legislation that would define consumer rights regarding how data about their activities was used. It suggests extending privacy protections to individuals who are not citizens of the United States and argues for action to ensure that data collected about students is used only for educational purposes. But the most significant findings in the report focus on the recognition that data can be used in subtle ways to create forms of discrimination." David E. Sanger and Steve Lohr in The New York Times.

In particular, White House fears you may pay more based on your race. "Businesses are increasingly collecting vast amounts of data on consumer behavior and assembling detailed profiles on individuals. That data could lead companies — either intentionally or inadvertently — to discriminate against people in pricing, employment, housing, health care, or other opportunities....The report urges government agencies to improve their technical expertise so they can better spot and crack down on illegal discrimination that relies on data collection." Brendan Sasso in National Journal.

Privacy rules long out of date, advocates argue. "Under a law crafted in 1986 called the Electronic Communication Privacy Act, e-mail and other digital content — like, say, a Gmail archive — stored online for more than six months or left unread can be requested by law enforcement by use of a subpoena rather than a probable cause warrant. Civil liberties and privacy groups have long argued ECPA is outdated. These groups have joined major tech companies like Google and Microsoft in the Digital Due Process Coalition, which is urging Congress to take action on the issue. The courts have also debated whether e-mails should have Fourth Amendment protections." Andrea Peterson in The Washington Post.

President's science and tech advisers weigh in, too. "A parallel report from the President's Council of Advisors on Science and Technology...also recommended that any new policies should focus on the how the data are used, rather than on the technical aspects of its collection — a nod to how quickly the processes by which tech companies gather information can change." Tom Hamburger and Hayley Tsukayama in The Washington Post.

Primary source: The PCAST report.

Here's how companies received the report. "The tech industry is calling on the Obama administration to focus on limiting government access to online data after a White House report focused on commercial users of consumer data. Tech companies and trade groups applauded the White House’s 'Big Data' report — which was released Thursday and largely focused on how companies collect and use large amounts of consumer data — but encouraged President Obama to focus on reforming national security and law enforcement surveillance." Kate Tummarello in The Hill.

Meanwhile, privacy advocates mostly cheered. Julian Hattem and Kate Tummarello in The Hill.

The report also recommended protections for foreigners. "The White House has ordered that US data privacy protections will soon be extended to non-Americans in an announcement that seems timed to take some of the heat out of Friday's meeting with German chancellor Angela Merkel. Though separate from the administration's earlier review of intelligence activities including the bugging of her phone, the report, led by senior adviser John Podesta, touches on many of the associated privacy concerns raised by the European Union in ongoing trade negotiations." Dan Roberts in The Guardian.

Other tech reads:

Apple, Facebook, others defy authorities, notify users of secret data demands. Craig Timberg in The Washington Post.

How cloud storage complicates the Supreme Court case over cell phone privacy. Brian Fung in The Washington Post.

How the Supreme Court could reshape the tech patent landscape. Laura Sydell in NPR.

Another animal interlude: Manatee drinks water from a hose.

3. It's jobs day — what to expect.

What the jobs number will mean for the Fed. "Reuters' poll of economists is expecting 210,000 net new seasonally adjusted jobs for April. If we hit that, or if we come close and see upward revisions to the February and March numbers, then everything will look fine. But if we fall short of expectations or see downward revisions to the past two months, then it's going to look like the Fed made a big error by standing still in the face of a weak quarter." Matthew Yglesias in Vox.

Explainer: What to look for in Friday's jobs report. Josh Mitchell in The Wall Street Journal.

Long read: The other jobs crisis — teenagers are being left behind. Lydia DePillis in The Washington Post.

Jobless claims: They unexpectedly shot up last week. Reuters.

Economists now think 1st-quarter GDP might have shrunk. Why? Weak construction data. "The government’s official reading of domestic growth clocked in at a puny annual rate of 0.1 percent, falling short of even the most modest expectations. That number is a preliminary estimate based on incomplete data and will be revised twice more. After the release, many economists wrote off the number as a fluke and predicted the data would be adjusted upward. That was yesterday. Today the Census Bureau released new data on construction spending that were weaker than not only the consensus forecast but also the government’s estimates in its calculations of the nation’s gross domestic product." Ylan Q. Mui in The Washington Post.

But new data suggest future growth looking stronger. "One day after a dismal report on growth in the first quarter of 2014, fresh data from the Commerce Department on Thursday on personal income and spending in March suggested that the economy may finally be shaking off the effects of the deep freeze. The better-than-expected numbers, with the Federal Reserve’s statement that the slowdown early this year appears to be easing, improved the outlook for renewed growth in the next few months." Nelson D. Schwartz in The New York Times.

Manufacturing grew by most in four months. "The Institute for Supply Management’s factory index rose to 54.9, the strongest so far this year, from 53.7 in March, figures from the Tempe, Arizona, group showed today. Readings above 50 indicate expansion." Shobhana Chandra and Victoria Stilwell in Bloomberg.

And consumer spending is up. "A day after data showed that the U.S. economy went into a deep freeze in the first quarter, new numbers suggest consumers made up for it in a big way once the weather improved....Household purchases rose 0.9 percent in March, the most since August 2009, when the economy was first emerging from recession. That’s on top of better spending data from February, when purchases increased 0.4 percent." Matthew Philips in Bloomberg Businessweek.

Other economic/financial reads:

Watchdog says Census didn't fiddle with jobs data in 2012. Jeffrey Sparshott in The Wall Street Journal.

Labor shortage besets home builders. Kris Hudson in The Wall Street Journal.

Fed seeks to avoid undue regulations, Yellen says. Martin Crutsinger in the Associated Press.

U.S. inflation ticks up but lags behind Fed target. Ben Leubsdorf in The Wall Street Journal.

'Frozen' interlude: Marines sing along to "Let It Go."

4. The minimum wage push is going local

Seattle mayor seeks $15 minimum wage. "Mayor Ed Murray presented on Thursday what he described as an imperfect but workable plan to increase the city’s minimum wage to $15 an hour, more than twice the federal minimum wage and one of the highest anywhere in the nation....Just as crucially, he said, the plan has broad political support, with a coalition of labor and business groups ready to push hard for it at the City Council, starting with the first hearings next week. But the plan, which in many other cities might be seen as a liberal Democratic agenda at the frontier of social and economic engineering, was immediately attacked not from the mayor’s right, but from his left." Kirk Johnson in The New York Times.

Explainer: 5 reasons to follow the local minimum wage battles. Eric Morath in The Wall Street Journal.

How the wage hike could affect Seattle. "It is entirely possible that as Seattle’s new minimum wage proposal takes effect, the poverty rate within the city limits will decrease. What remains to be seen, however, is if the new proposal decreases the poverty rate by raising the market incomes of low-wage workers currently residing in Seattle or if it instead prices some number of less-skilled women and men out of Seattle’s housing market by reducing their market incomes, either by forcing them to exit the city’s formal labor market to seek lower-wage employment in neighboring jurisdictions or by encouraging local employers to reduce work hours." Reihan Salam in National Review.

Nationally, large majorities support boosting minimum wage — but they don't vote on it. "Democrats have yet another issue on which Republicans in Congress have now voted against the will of the vast majority of Americans: raising the minimum wage. The Senate's defeat of an increase in the minimum wage to $10.10 Wednesday — on a near-party-line vote — comes as upwards of three-fourths of Americans say they want to increase the minimum wage. But as with many other issues...those national polls completely over-sell the actual electoral impact of voting against a popular proposal." Aaron Blake in The Washington Post.

Background reading: Economists disagree on whether minimum wage kills jobs. Brad Plumer in The Washington Post.

Unemployment extension in Boehner's hands, Heller says. Sabrina Siddiqui and Arthur Delaney in The Huffington Post.

Sports interlude: Tennis player hits last-ditch shot from the ground — and somehow wins the point.

5. Two areas where the U.S. is trying to crack down on sexual assault

Pentagon sees surge in reports of sexual assault among service members. "The number of U.S. service members who reported being sexually assaulted surged by 50 percent last year, the Pentagon announced Thursday, the latest sign of how the military has struggled to cope with sex crimes in the ranks. Military officials said they didn’t know whether the sharp increase meant that more crimes were actually committed, but they added that the evidence suggested that victims were simply more willing to come forward....At a minimum, however, the startling figures released Thursday illustrated how sexual violence is much more prevalent in the armed forces than commanders previously realized." Craig Whitlock in The Washington Post.

And the Education Dept. releases list of schools under investigation for sexual assaults. "The Department of Education on Thursday for the first time issued a list of the colleges and universities that are under investigation for violations of the federal civil rights law for their handling of sexual violence and harassment complaints. There are 55 schools in 27 states and the District of Columbia on the list....The new disclosure comes as the White House Task Force to Protect Students from Sexual Assault took steps this week to help college students understand how to report campus rapes and sexual assaults and put out new public service announcements calling for students to respect the need for consent." Renee Schoof in McClatchy Newspapers.

Read: The list of schools under investigation. The Washington Post.

When college sexual-assault panels fall short, and when they help. "Colleges find themselves increasingly pressed to act as pseudo-courts. Schools have been under fire for discounting complaints, mismanaging cases and meting out punishments that look more like slaps on the wrist. By all accounts, there's plenty of room for improvement. Still, college discipline procedures can make certain allowances that courts cannot, and school panels can step in when an alleged victim is wary of going to court." Tovia Smith in NPR.

Kitten Whac-a-Mole interlude: No kittens were harmed in the making of this video.

Wonkblog roundup

Why Big Meat hates "Made in the USA" labels. Lydia DePillis.

The holes in the Clinton economic record that should worry Hillary. Zachary Goldfarb.

Why thousands of homeowners are getting money for mortgage abuses they never suffered. Danielle Douglas.

Obamacare’s Hispanic enrollment is low, new HHS report shows. Jason Millman and Sandhya Somashekhar.

Chart: If you don’t go to the dentist, your teeth will literally fall out of your head. Christopher Ingraham.

4 ways to stop the U.S. from becoming a Piketty-style oligarchy. Matt O'Brien.

Why the first-quarter GDP may get even uglier. Ylan Q. Mui.

The other unemployment crisis: Teenagers are being left out of the recovery. Lydia DePillis.

The economics of adultery. Max Ehrenfreund.

Believe it or not, Congress gets more done in election years. Christopher Ingraham.

Et Cetera

Why Congress can't fix our nation's crazy chemical-safety laws. Jason Plautz in National Journal.

When Common Core becomes a punchline. Stephanie Simon in Politico.

Conservatives revolt against Boehner on immigration reform. Seung Min Kim in Politico.

White House urges companies to snub Putin forum. Ed Crooks and Richard McGregor in The Financial Times.

Bipartisan bill would approve Keystone XL pipeline. David Espo in the Associated Press.

Scalia gets his facts wrong in EPA dissent. Associated Press.

Got tips, additions, or comments? E-mail us.

Wonkbook is produced with help from Michelle Williams.

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