by Marc A. Thiessen
The Obama administration is celebrating that it has achieved its (downwardly revised) goal of signing up more than 6 million Americans for Obamacare by 11:59 p.m. March 31. Mission accomplished!
Not quite. The administration has not revealed how many of those 6 million people have paid their premiums. If you have not paid, you have not actually “enrolled.” It’s like putting merchandise in your Amazon cart but never clicking “buy.”
Besides, the number that matters is not how many Americans signed up for Obamacare but rather how many previously uninsuredAmericans signed up for Obamacare. By that standard, Obamacare may be headed for an epic failure.
Recall that between 5 million and 6 million Americans lost their health plans because of Obamacare last fall. If the administration now succeeds in signing up 5 million to 6 million previously insured Americans, it will have achieved . . . nothing. Breaking even is no great accomplishment.
And let’s not forget: Many of those new Obamacare sign-ups are self-sufficient people who were previously paying their own way and now receive government subsidies for insurance. Creating government dependency is not progress — it’s a step backward.
The stated goal of Obamacare was not to move millions of privately insured Americans into taxpayer-subsidized health coverage. The goal was to cover the uninsured. That was the justification for all the chaos and disruption Americans have experienced — and that is the standard by which the administration should be judged.
So how is it doing? We don’t know yet, but the signs are not good. A March survey by McKinsey & Co. found that only 27 percent of consumers who had purchased new coverage in the individual insurance market in February were previously uninsured — up from 11 percent in January. But McKinsey also found that the payment rate for the previously uninsured was just 53 percent, compared with 86 percent for the previously insured. We don’t know how many of those policies were purchased through Obamacare, but remember: Those who sign up and do not pay are not actually enrolled.
Goldman Sachs is projecting that only 1 million Obamacare sign-ups will come from previously uninsured Americans. Indeed, it estimates that the number of total signups will be just 4 million — not 6 million, as the administration claims — because “HHS figures . . .count all persons who selected an ACA exchange plan regardless of whether or not they have actually completed the enrollment process by paying their premium.” Goldman Sachs also anticipates that fully 75 percent of all the Obamacare sign-ups will be from people who already had insurance.
The administration faces a similar problem with Medicaid enrollments. President Obama recently declared, “We’ve got close to 7 million Americans who have access to health care for the first time because of Medicaid expansion.” That statement is flat untrue.
The president assumes that every single one of those Medicaid enrollees is getting health insurance for the first time because of Obamacare. But according to his own Department of Health and Human Services, that number includes people previously enrolled in Medicaid who are deemed eligible for another year, as well as people who would have been eligible under the law before Obamacare. The fact is, HHS does not know how many of the Medicaid signups are “newly eligible” and how many would have signed up anyway. If HHS doesn’t know, how can the president know? The answer is: He can’t.
Over any given six-month period since 2008, between 1.5 million and 2.5 million people have joined the Medicaid rolls just by the natural expansion of the program. Much of that figure, then, is likely just regular Medicaid growth that has nothing to do with Obamacare. Moreover, the health consulting firm Avalere examined the state-by-state numbers and estimates that only 1.1 million to 1.8 million of the claimed enrollees could be attributed to Obamacare. That’s a lot fewer than 7 million.
The Obama administration is so anxious for some good news about this law that if it doesn’t have any, it just makes some up.
There are other problems with Obamacare — coming cancellations of employer-based plans, not having enough young healthy enrollees to play for the old and the sick, skyrocketing deductibles and massive premium hikes despite Obama’s pledge to “cut the cost of a typical family’s premium by up to $2,500 a year.”
But the whole point of Obamacare was supposed to be to cover the uninsured. The president himself set the standard — giving Americans “access to health care for the first time” — by which Obamacare should be judged. So hold him to that standard, and ignore the hyped-up numbers touting how many people “sign up” for Obamacare.
What matters is how many of those who actually enroll were previously uninsured.
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Marc A. Thiessen writes a weekly column for The Washington Post on foreign and domestic policy. He is a fellow at the American Enterprise Institute.