Medicare part D had a troubled rollout but its problems were really nothing compared to the launch of Obamacare.
Monday Ezra Klein published a post at Wonkblog stating that Obamacare would likely succeed despite the problems with healthcare.gov. The example he uses to justify this claim is Medicare part D, which also had a rocky start but went on to be judged a success. Klein writes of Medicare part D:
Medicare Part D…was a polarizing national law that
suffered from a terrible rollout. At launch, it was less popular even than Obamacare. In May 2006 — so, five months after its launch — a CBS/New York Times poll found
48 percent of seniors said they didn’t plan to join and 81 percent said
the George W. Bush administration should extend the deadlines. A Gallup
poll from about the same time showed 53 percent of seniors thought the law flatly wasn’t working.But the program didn’t fail. Mark McClellan, who led the rollout
effort, recalls that “by the spring of 2006 most seniors signed up.
Every senior had heard about this program or knew people in it. And
everyone was familiar with the delayed enrollment penalty. Those things
together led to a big bump before open enrollment ended.” Today Medicare
Part D is widely considered a success. Over 90 percent of seniors say
they’re happy with it.
Klein makes it sound as if Medicare part D was unpopular but somehow was saved by a “big bump” near the end of enrollment. That’s not quite what happened.
In mid-November 2005 the government began the rollout of the new Medicare part D program. The official HHS goal was to see 28-30 million people enrolled by mid-May when the enrollment period closed. Many of those would be auto-enrolled in one way or another but there was a significant subset of people who would need to sign up for stand-alone prescription plans either on the web or by phone.
So how did it go? Klein is correct that there were glitches and problems with the website which led some to proclaim it a failure. Sen. Hillary Clinton wanted to scrap it and start over. Rep. Pelosi thought it should be replaced. Harry Reid called it a “mess” and claimed that the Senate had given it a vote of no confidence.
But even as the program was taking a hit in the media, it continued to enroll a lot of people. One million signed up for stand-alone coverage in the first 28 days. Two months in that number was 3.6 million. After three months (halfway through the enrollment period), the total was 5.3 million. Eventually, just shy of 9 million people would sign up for stand alone coverage. That does not include those who signed up for a Medicare Advantage plan.
Notice that the growth of the stand-alone prescription program was strong from the start and maintained a steady pace over the entire enrollment period. This is contrary to Klein assertion that “with these kinds of laws…enrollment begins as a trickle and
spikes at the end.” That’s simply not what happened.
As for the overall goal of 28-30 million, in April 2006 HHS Sec. Leavitt announced “With a month to go, we’ve passed our projections of 28 to 30 million enrollees in the first year.” This all took place before the polls that Klein cites on the law’s unpopularity. So despite the tone of Democrats, the negative press coverage and the polling, Medicare part D exceeded expectations when it came to the enrollment.
At this moment the same can not be said about Obamacare. CBO estimated that 7 million would sign up for plans but just a few graphs later Klein writes “I wouldn’t bet very much money that Obamacare’s exchanges are insuring a
diverse risk pool composed of seven million souls by the end of 2014.” In other words, don’t count on 7 million enrollees or the stated goal of 38 percent of enrollees being under 35 years of age. Neither outcome seems likely at this point.
At a minimum, Obamacare should not be judged a success until the number of people enrolled exceeds the number who were dropped (around 5 million). It’s still not clear when or if that will happen.
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