The Conversation

Curb Your Obamacare Enthusiasm

Obamacare enrolled nearly 2 million people in paying plans in the first three months, which means it only fell about 50 percent short of its goal, i.e. 1.3 million people. That's the good news.

The bad news is that Obamacare is still fighting an uphill battle, having caused via subsequent regulations the cancellation of millions of insurance policies. In other words, we still haven't reached the break even point. It's likely that Obamacare has yet to net a single digit gain in the number of people insured over the status quo.

It's not clear when that line will be crossed but it's important to keep in mind that the net figure matters more than the gross one. Bob Laszewski has been making this point for weeks and returned to it Sunday with a twist. Even if we ignore the net vs. gross issue, is Obamacare really a big success?

The good news is that Obamacare will likely enroll almost 2 million people in 2013.

Even if we ignore that fact that many of these people were previously insured and had to replace cancelled policies (there were more than 400,000 subsidy eligible cancellations in California and Washington alone), 2 million people are only 10% of the 20 million uninsured in the U.S. who are eligible to buy coverage in the health insurance exchanges.

In other words, if there had been no cancellations at all, this would be a modest achievement thus far. If you include the cancellations we're getting nowhere fast.

And then there's the lingering question which the Obama administration refuses to answer. Here is the final paragraph from a Sarah Kliff Wonkblog post published yesterday:

And, as health policy experts are very quick to point out, hitting 7 million enrollees isn't some magical benchmark, where the Affordable Care Act suddenly has the manpower to work. If the Congressional Budget Office had projected 5 million sign-ups this year -- or 15 million -- we'd have a much different measuring stick. What seems to matter more is the mix of who signs up, whether they tend to be older and sicker -- or include lots of healthy, younger people, too. While the White House has repeatedly promised demographic information, it has not yet released this type of data.

Kliff is a supporter of the law but she has not been shy about pointing out instances where the administration has refused to release important data. Expect her final paragraph to become a lead paragraph if the administration balks over the next couple weeks. But as of right now, HHS is hiding the most important metric. That's probably not a sign that things are going well. 


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