“ACA Enrollment Tops 6 Million”: The Imminent Implosion Of The Affordable Care Act Has Been Cancelled
The expectation all along was that health care enrollment through the Affordable Care Act would spike shortly before the March 31 deadline. As of this afternoon, those expectations are very much in line with reality.
More than 6 million people have signed up for health insurance on the new exchanges, a number that signals a tremendous last-minute surge, the White House said Thursday.
President Barack Obama told volunteers and navigators helping sign people up that 1.5 million people visited HealthCare.gov on Wednesday – the highest-traffic day yet. Officials have said they logged more than a million visits each day so far this week.
Remember, this total only refers to consumers who’ve signed up for private coverage through exchange marketplaces. It doesn’t include Americans who’ve gained coverage through Medicaid expansion. For that matter, clearing the 6-million milestone is an important threshold, but there’s still time remaining in the open-enrollment period and it’s not unrealistic to think we’ll see 6.2 million by next week.
“We are seeing near-record numbers of consumers coming to check out their options and enroll in coverage. Yesterday alone, we had 1.5 million visits to HealthCare.gov and took more than 430,000 calls at our 24/7 call center,” said Marilyn Tavenner, head of the Centers for Medicare and Medicaid Services.
As of March 1 – not quite four weeks ago – 4.2 million Americans had enrolled through exchanges, suggesting we’ve seen nearly two million consumers sign up in less than a month.
It’s easy to forget, but this seemed like a pipe dream last fall. In October, the first month of the open-enrollment period, just 106,185 consumers signed up for insurance through an exchange – causing Republicans to not only celebrate, but to openly mock the system by noting a variety of sports venues that hold more than 106,185 attendees.
It was obviously proof, we were told at the time, that the Affordable Care Act itself was “hurtling toward failure.”
Oops.
The enrollment totals must seem literally unbelievable to Republicans, who managed to convince one another that the ACA is not only catastrophically flawed, but on an inevitable road towards imploding.
Indeed, as Paul Krugman noted earlier today, “[P]eople in the GOP are still working with a completely wrong narrative — namely, that Obamacare is failing, and that these are desperate ploys to save a sinking ship. The reality is quite different: enrollments have clearly surged in the final month…. How will the GOP respond when the numbers come in?”
I don’t know the answer to that question, but I suspect it’ll have something to do with Benghazi.
To reiterate a point from early February, those who say they hate “Obamacare” won’t want to hear this, but the imminent implosion of the Affordable Care Act has been cancelled.
What’s more, this is less of a comeback story than a story of normalcy and effective governance. There was a fair amount of panic in November – remember the pieces that predicted “Obamacare may destroy all of liberalism forever”? – but there were plenty of voices counseling patience. There were problems, but they were surmountable. There were elements that were broken, but they could be fixed.
The recent progress, in other words, isn’t some remarkable fluke the White House achieved through a Hail Mary pass. Rather, what we’re seeing now is progress many of us expected to see all along.
By: Steve Benen, The Maddow Blog, March 27, 2014
“The Real Truth About ObamaCare”: Conservatives Need To Help Fix It, Or Face Their Worst Nightmare!
Despite the worst roll-out conceivable, the Affordable Care Act seems to be working. With less than two weeks remaining before the March 31 deadline for coverage this year, five million people have already signed up. After decades of rising percentages of Americans’ lacking health insurance, the uninsured rate has dropped to its lowest levels since 2008.
Meanwhile, the rise in health care costs has slowed drastically. No one knows exactly why, but the new law may well be contributing to this slowdown by reducing Medicare overpayments to medical providers and private insurers, and creating incentives for hospitals and doctors to improve quality of care.
But a lot about the Affordable Care Act needs fixing — especially the widespread misinformation that continues to surround it. For example, a majority of business owners with fewer than 50 workers still think they’re required to offer insurance or pay a penalty. In fact, the law applies only to businesses with 50 or more employees who work more than 30 hours a week. And many companies with fewer than 25 workers still don’t realize that if they offer plans they can qualify for subsidies in the form of tax credits.
Many individuals remain confused and frightened. Forty-one percent of Americans who are still uninsured say they plan to remain that way. They believe it will be cheaper to pay a penalty than buy insurance. Many of these people are unaware of the subsidies available to them. Sign-ups have been particularly disappointing among Hispanics.
Some of this confusion has been deliberately sown by outside groups that, in the wake of the Supreme Court’s “Citizens United” decision, have been free to spend large amounts of money to undermine the law. For example, Gov. Rick Scott, Republican of Florida, told Fox News that the Affordable Care Act was “the biggest job killer ever,” citing a Florida company with 20 employees that expected to go out of business because it couldn’t afford coverage.
None of this is beyond repair, though. As more Americans sign up and see the benefits, others will take note and do the same.
The biggest problem on the horizon that may be beyond repair — because it reflects a core feature of the law — is the public’s understandable reluctance to be forced to buy insurance from private, for-profit insurers that aren’t under enough competitive pressure to keep premiums low.
But even here, remedies could evolve. States might use their state-run exchanges to funnel so many applicants to a single, low-cost insurer that the insurer becomes, in effect, a single payer. Vermont is already moving in this direction. In this way, the Affordable Care Act could become a back door to a single-payer system — every conservative’s worst nightmare.
By: Robert Reich, The Robert Reich Blog, March 22, 2014
“At The Intersection Of Calendars And The ACA”: The Success Of The System Will Not Rise Or Fall Based On Monthly Tallies
The Affordable Care Act enrollment figures for February were released yesterday afternoon, and for the most part, the numbers looked pretty good for those hoping to see the U.S. system succeed.
But news consumers can be forgiven for thinking the opposite. The Hill ran this headline: “ObamaCare enrollments dip.” The Washington Post had a similar message: “Obamacare enrollment drops off in February.” The conservative Washington Examiner told readers: “Obamacare signups slow down in February.”
Sounds discouraging, doesn’t it? January’s enrollment totals were heartening, but if you just skimmed the headlines out of D.C., you’d think February represented a step backwards.
The months HHS has been using for tabulation don’t correspond precisely to the calendar, because of state reporting methods and where weekends fall. As it turns out, “February” is actually February 2 through March 1. That’s 28 days. “January” is actually December 29 through February 1. That’s 35 days. Plug in the numbers, and you’ll see the average daily enrollment for January was 32,744 and for February it was 33,673. As you can see in the graph, the pace actually increased a bit. Among the very few who noticed were Charles Gaba of ACASingups.net and Sy Mukherjee of ThinkProgress.
At a superficial level, the raw monthly totals offer a misleading picture. Someone sees 1.2 million sign-ups in January, followed by 943,000 in February. That looks like a drop.
Until we’re reminded that February is the shortest month.
Stepping back, it’s worth noting that these month-to-month totals are interesting, but their broader importance is limited. I always make a point to highlight the totals as a way of documenting ACA progress, and there’s a political salience as more Americans get invested – literally and figuratively – in the law’s future, but the success of the system will not rise or fall based on monthly tallies and the degree to which they meet preliminary projections.
As Rachel has noted on the show more than once, when a very similar system was established in Massachusetts eight years ago, officials worked under the assumption that enrollment would be slow at first and would then improve in time. In the very first month of the state’s open-enrollment period, a grand total of 123 residents of Massachusetts actually signed up.
And while that may sound like a disaster, no one much cared – in fact, no one even bothered to acknowledge the total at the time, and the figure was only dug up later.
The Affordable Care Act is following a similar trajectory. And since the Massachusetts system is working quite well, that’s probably a pretty good sign.
By most estimates, by the end of March, a little over 5 million consumers will have enrolled through exchange marketplaces, and a similar number will have gained coverage through Medicaid. That’s not quite what the CBO projected before the process began – whether the 7 million figure could have been reached if healthcare.gov worked from the outset we’ll never know – but it’s a perfectly fine number when it comes to sustainability.
Keep this in mind the next time you’re perusing the Beltway media’s headlines about the system’s progress.
By: Steve Benen, The Maddow Blog, March 12, 2014
“Surprise, Surprise”: The Real Numbers On ‘The Obamacare Effect’ Are In, Now Let The Crow Eating Begin
After years of negative speculation on the part of the opponents of Obamacare, hard data is finally coming in with respect to the anticipated negative side-effects of the law.
The results are guaranteed to both surprise and depress those who have built their narrative around the effort to destroy the Affordable Care Act.
Let’s begin with the meme threatening that healthcare reform will lead to a serious decline in full-time employment as employers reduce workforce hours to below 30 per week in the effort to avoid their responsibility to provide health benefits to their employees.
It turns out that there has, in fact, been no such rush to reduce work hours. Indeed, numbers released last week reveal that precisely the opposite is taking place.
According to the Bureau of Labor Statistics (BLS), the number of part-time workers in the United States has fallen by 300,000 since March of 2010 when the Affordable Care Act was passed into law. What’s more, in the past year alone—the time period in which the nation was approaching the start date for Obamacare—full-time employment grew by over 2 million while part-time employment declined by 230,000.
And it gets even more interesting.
Despite the cries of anguish over the coming destruction of private sector work opportunities at the hands of Obamacare, it turns out that the only significant ‘cutter’ of work hours turns out to be in the public sector where cops, teachers, prison guards and the like are experiencing cuts in work time as cities, states and universities seek to avoid the obligations of the health reform law.
Correct me if I am wrong, but is it not the very same folks who strenuously oppose Obamacare who are constantly screaming for smaller government? Are these not the same people who have, for as many years as I can recall, been carping about swollen government payrolls?
But the false narrative that has been peddled to make us believe that the private sector can’t wait to lower our hours of employment turns out not to be the only false note being played by anti-Obamacare forces.
For months now, we have been pounded with the story of the millions of Americans who have lost their non-group, individual health insurance policy due to cancellations forced by Obamacare.
Yet, a new study just out by Lisa Clemons-Cope and Nathaniel Anderson of the Urban Institute tells a very different story.
How many times have readers, along with television and radio audiences, read or heard me point out that few ever expected to hang onto their individual insurance policy for longer than a year or two following date of purchase? Long before there was Obamacare, it was always clear that when someone purchased an individual health instance policy, it was pretty much a given that they would either be moving on to an employer provided group plan when they get a job or that their policy would respond to the ordinary, pre-Obamacare changes that occurred from year to year and result in the consumer having to purchasing a new plan after a short period of time.
Indeed, it was this very reality that made it clear to those who follow the health insurance industry that Obama’s “If you like your policy you can keep your policy” proclamation was a near impossibility for those participating in the individual marketplace. This simply wasn’t the way the individual market worked.
The Urban Institute study bears this out, noting that “the non-group market has historically been highly volatile, with just 17 percent retaining coverage for more than two years.”
While Obamacare foes have been quick to jump on this statistic when it comes to condemning the President for uttering his promise that you could keep your insurance if you are happy with your policy, the same people have somehow managed to miss the reality that a huge percentage of those who received cancellation notices last year were going to get that notice even if the Affordable Care Act had never existed.
But that is not all that critics have been missing as they’ve sought to exploit the supposed high number of cancellations they claim are due to Obamacare.
To find out just how many people have really been put into an insurance fix, the Urban Institute’s Health Reform Monitoring Survey, in December of 2013, asked people between the ages of 18 and 64 the following question:
“Did you receive a notice in the past few months from a health insurance company saying that your policy is cancelled or will no longer be offered at the end of 2013?”
The following bar published in Health Affairs provides the results—
Note that the number of people who saw their policy cancelled because it did not meet the Obamacare minimum requirements was 18.6 percent—dangerously close to the 17 percent of individual policyholders who were losing their individual market policies pre-Obamacare.
Also note that the 18.6 percent equates to roughly 2.6 million people whose plans were cancelled as a result of Obamacare—a number well below the estimates of 5 million or considerably more being tossed about by Obamacare opposition.
So, what happens to these folks who saw their health insurance policy cancelled?
According to the Urban Institute researchers :
“While our sample size of those with non-group health insurance who report that their plan was cancelled due to ACA compliance is small (N=123), we estimate that over half of this population is likely to be eligible for coverage assistance, mostly through Marketplace subsidies. Consistent with these findings, other work by Urban Institute researchers estimated that slightly more than half of adults with pre-reform, nongroup coverage would be eligible for Marketplace subsidies or Medicaid.”
So what does this data tell us?
As a result of at least half of those cancelled being able to either enroll in a Medicaid program or receive subsidies on the healthcare exchanges, many—if not most—will now find health care coverage at a price lower than previously paid while greatly improving the quality of coverage.
Still, roughly one million people will have to replace their cancelled policy with something that may cost them more. This is not a good thing but it is far, far less dramatic than what we’ve been hearing. It is also a part of the expected upheaval that has always—and will always—result from the passage of reforms designed to benefit the greatest number of people. Traditionally, those who are disadvantaged in this way find that things are sorted out in amendments to the initial legislation, amendments that can only result when Republicans in Congress stop playing politics and begin the serious work of making the law better for Americans.
There is another problem noted in the study—
Because of the amount of focus placed on scaring the you-know-what out of people when it comes to the alleged dire effects of Obamacare rather than educating them, people remain in the dark as to what is available on the exchanges or via the state Medicaid programs.
Per the Urban Institute study—
“Yet making the best enrollment choice may be difficult for consumers. HRMS findings show that many people are not aware of the new state Marketplaces, few know whether their state is expanding Medicaid, and many lack the confidence to enroll, make choices, and pay their premiums.”
Once again, politics trumps policy and the critical needs of those our elected officials are sworn to serve.
I highly encourage everyone—whether friend or foe of healthcare reform—to take a look at the study cited above and the BLS statistics. While most all would agree that there are some repairs that need to be made to the Affordable Care Act, workable fixes designed to benefit the public and improve American healthcare cannot happen so long as politicians, pundits and special interests are devoted to lying about what Obamacare means and what it does not mean to the American public.
Facts matter—even when they screw up an effective disinformation campaign.
UPDATE: Monday, 12:15pm EST:
The news just keeps on coming.
The Gallup-Healthways Well-Being Index is out this morning and reveals that 15.9 percent of American adults are now uninsured, down from 17.1 percent for the last three months of 2013 and has shown improvements in every major demographic group with the exception of Hispanics who did not advance.
That translates roughly to 3 million to 4 million people getting coverage who did not have it before.
According to Gallup, the number of Americans who still do not have health insurance coverage is on track to reach the lowest quarterly number since 2008.
This is one statistic that is going to be tough for Obamacare critics to overcome.
By: Rick Ungar, Op-Ed Contributor, Forbes, March 10, 2014
“The GOP’s Health Crisis”: The Republican Party’s Worst Nightmare Is Coming True
Oh dear. The Republican Party’s worst nightmare is coming true. Obamacare is working.
The news that nearly 1.2 million people signed up last month for insurance through the Affordable Care Act exchanges is highly inconvenient for GOP candidates nationwide. It looks as if the party’s two-word strategy for the fall election — bash Obamacare — will need to be revised.
Wednesday’s status report on the health-insurance reforms was by far the best news for Democrats and the Obama administration since the program’s incompetent launch. January was the first month when new enrollments surpassed expectations, as the balky HealthCare.gov Web site began functioning more or less as intended.
Cumulatively, 3.3 million people had chosen insurance plans through the state and federal exchanges by the end of January. That is fewer than the administration had originally hoped but well above the predictions of critics who believed — or hoped — that the program would never succeed. The Congressional Budget Office projects that 6 million people will have chosen plans through Obamacare when the initial enrollment period ends March 31, down from a pre-launch estimate of 7 million. Not bad at all.
The numbers are even more encouraging when you look more closely. The proportion of young people — from 18 and 34 — who chose insurance plans through the exchanges increased slightly to 27 percent, compared with an average of 24 percent in previous months. This is important because premiums would have to rise if not enough young, healthy people enrolled.
The administration had hoped the percentage of young enrollees would reach about 40 percent. But the January figure — and the rising trend — should put to rest any notion that the whole program could go down the drain in an actuarial “death spiral.” Administration officials are convinced this won’t happen.
According to the January report, about 80 percent of those signing up for Obamacare are eligible for subsidies to help them pay for insurance. The administration believes, but does not have the data to prove, that most of the new enrollees were previously uninsured.
These figures do not include the additional people who have been determined newly eligible for insurance under the federal-state Medicaid program. Overall, the program appears to be doing exactly what it was designed to do: make health insurance accessible and affordable for those who truly need it.
The Affordable Care Act could be doing even more if Republican governors such as Rick Perry of Texas and Rick Scott of Florida were not doing all they could to sabotage the program. But even in states that refused to set up their own health-insurance exchanges or to expand Medicaid eligibility, growing numbers of the uninsured are obtaining coverage.
Politically, this is terrible news for Republicans who hoped that the botched Web site launch and President Obama’s misleading “you can keep your insurance” pledge would be the gifts that kept on giving.
Bashing Obamacare will always have resonance for the GOP’s conservative base. But if you’re trying to win the votes of independents, it’s more profitable to target a failed program than a successful one.
Critics will doubtless try to blame Obamacare for anything bad that happens to anyone’s health insurance before the November election. But all of this is just noise without the central narrative of a “failed program.”
Attack ads against vulnerable Democratic senators, such as Kay Hagan of North Carolina and Mary Landrieu of Louisiana, are already trying to paint Obamacare as a character defect — the president and his supporters “lied” when they said everyone could keep their insurance. The response from Democrats should be to shift the focus to the actual program and its impact. Imperiled incumbents can point to constituents who are benefiting from the Affordable Care Act in life-changing ways.
If you assume that Affordable Care Act enrollment remains on its current trajectory, the February numbers should look even better. Polls consistently show that even if voters have mixed views about the health-care reforms, most do not want to see them repealed. By the fall, the whole Obamacare-is-a-disaster line of attack could sound stale and irrelevant.
Republicans may even have to take the drastic step of saying what they advocate, rather than harping on what they oppose. Is there a GOP plan to cover those with preexisting conditions? To cover the working poor? Is expanding access to health insurance really such an awful thing?
Sorry, I didn’t catch what you said.
By: Eugene Robinson, Opinion Writer, The Washington Post, February 13, 2014
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