OBAMACARE’S CRITICS have had a bad week. On Thursday, President Obama announced that 8 million people have enrolled in new health insurance plans through the Affordable Care Act’s marketplaces, and a significant portion of them are young Americans. Yes, we need to learn more about the numbers. And yes, a lot needs to happen to complete the ACA’s phase-in. The debate about how well the law is working is not over. But the initial figures are encouraging, and Mr. Obama is right to insist that continued Republican demands for repeal are unproductive and unwise.
To discount solid enrollment numbers, Republicans have variously complained that not many people who previously were uninsured may be signing up, premiums are rising, people can’t see the doctors they prefer and taxpayers are getting soaked.
But the Obama administration wasn’t the only one with a new analysis of the law this week. In its latest estimates on the effects of the ACA, the nonpartisan Congressional Budget Office found that the percentage of Americans with insurance is set to go up. The analysts projected that 84 percent of the non-elderly population will have insurance this year, instead of 80 percent before the ACA. In 2016, the share will rise to 89 percent.
The CBO found that premiums in the new marketplaces for individual insurance buyers are not as high as many experts — including the CBO itself — expected, and that they will remain below projections. This indicates that a basic trade-off embedded in the law may well be cheaper than anticipated. The ACA requires that insurance plans in the individual marketplace provide comprehensive basic health benefits to all comers, which was not the case in the old system. Some individual purchasers — those who used to have skimpy coverage, for example, or who benefited from the discrimination against the elderly and the sick on which the old system relied — will pay more. Many others, however, will not, especially after they get government assistance to buy insurance. And people with preexisting conditions or other problems will no longer be priced out. That these worthwhile reforms are not expected to result in premiums as high as experts once projected is good news for individual buyers and the federal budget. The CBO reckons that the government will save about $5 billion this year and $104 billion over the next decade.
Part of the reason for the better-than-expected premium news is that health insurers have found ways to cut costs that do not involve turning away the sick or refusing to pay for treatment of certain basic illnesses. One cost-cutter, the CBO noted, has been narrowing the networks of doctors and specialists insurance companies do business with. Patients might object, but the new marketplaces appear to be compelling providers to compete to keep costs down.
The Obama administration has a lot more work to do: After this year’s big push, the marketplaces are not even half way to enrolling the 25 million or so customers the CBO expects eventually will sign up. Temporary measures to provide financial stability to the marketplaces will phase out over the next few years. And narrower networks must not result in people lacking timely access to basic care. Even so, the news about Obamacare is good, even if Republicans can’t quite bring themselves to admit it yet.
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