YOU CAN forgive a little football-spiking, even if Obamacare is far from the end zone. The White House this week announced that the number of people who enrolled in new individual health-care insurance plans under the Affordable Care Act topped 7 million and could still rise. According to figures collected by ACASignup.net’s Charles Gaba, an additional group of around the same number found coverage from two federal health programs, Medicaid and CHIP. Several million more Americans under the age of 26 have been able to stay on their parents’ plans. Not all of those people were uninsured to begin with; some had to move off old plans, and that policy shakeup hasn’t always been easy. But this week’s news is among the first of what we hope will be many signs that the health-care law is working toward its primary goal: enrolling many Americans into decent, comprehensive plans in sustainable marketplaces.
We would be expressing the same hope even if the number hadn’t crossed 7 million: The country has advanced a few crucial yards. There is still a lot we do not know about how the system is taking hold. There is still a lot that needs doing to make sure it works. And it is not all on the Obama administration to see it through.
The much-improved HealthCare.gov Web site performed far better on Monday, the last day of open enrollment, than in its disastrous debut, handling more than 4.8 million visits and 185,700 concurrent users. Officials should hope and plan for interest in enrollment to increase next year, after people hear about others’ experience with the system and after some get hit with fees for lacking insurance.
But much of the rollout is in the hands of state leaders. Several states that set up their own exchange Web sites, such as Oregon and Maryland, failed. Maryland improved its numbers at the tail end of the enrollment period, despite a management fiasco that the state is still resolving. On Tuesday, Maryland officials decided to ditch their buggy system and import the exchange software that Connecticut developed . It’s good they are cutting their losses and moving on. States shouldn’t stand on pride if their sites are hopelessly broken. But to ensure things go more smoothly, and in the interest of honest government, the public deserves a sense of what went wrong in Maryland and some accountability for those who fouled up the rollout.
At least Maryland’s leaders are trying to get people covered. In about half the states, Republicans have refused to expand Medicaid programs under the ACA, even though the federal government will pay almost the entire cost, in perpetuity, to cover more poor Americans through the state-federal insurance scheme. If Republican leaders don’t like traditional Medicaid, they can take the money and cover poor people some other way. But it makes no sense to turn it down.
Even after this year’s enrollments, tens of millions of people, including undocumented immigrants, will still be uninsured. After a solid start, it’s time for everyone, Democrat and Republican, to move on to the next stage.
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