On October 1, 2013, insurance exchanges launched across the country, allowing those who had low quality or non-existent health insurance a chance to register for new plans that it was hoped would save them money, provide better coverage and improve their health. From the moment they went live, the sites were flawed, crashing or refusing to save information, refusing to load, or otherwise failing. Republican politicians, especially those in Congress, made speeches about the debacle, hosted inquiries and demanded resignations. The public, meanwhile, kept registering. Now, open enrollment for Obamacare is closed. Has the program succeeded, or has it failed?
At least 7,0410,000 people would probably say it was a success. That’s the number that the administration says have picked a plan during the 6 month open enrollment period, not including those whose applications are still pending. “We surpassed everyone’s expectations,” said White House spokesman Jay Carney, referring to a Congressional Budget Office estimation that 7 million people would be the target for a successful enrollment. Amazingly, much of that traffic may have been last minute enrollees, as “more than 4.8 million visits were made to HealthCare.gov and 2 million calls were made to the call center,” on Monday, March 31, 2014, the last day of open enrollment, according to CNN.
Still, a number of questions remain. Will all of those who picked plans actually pay for them, making enrollment official? Odds are, yes, they will. Between 80 and 90 percent of those who have enrolled have already paid, according to Health and Human Services Secretary Kathleen Sebelius, which leaves a small number left to finish the transaction. And, with a penalty to be levied on those who do not purchase insurance (although the initial year’s penalty is a small one), there isn’t much impetus not to finalize the process.
The biggest concern that remains, however is the demographic of those who have applied. The administration made no secret that a large number of enrollees need to be younger, healthier applicants in order to balance out the number of people expected to enroll that would require more costly services — especially those who are poor and likely to have more health issues and those who have been unable to get insurance due to pre-existing conditions. As the New Yorker notes, however, that may not be as big of a deal as everyone is making it out to be.
“[T]he A.C.A., although it prohibits insurers from charging people more based on their health or pre-existing conditions, does allow insurers to charge people more based on their age. So while young people can be expected to rack up lower health-care costs, they’re also going to be paying less in premiums—ones they may consider a good bet,” writes James Surowiecki. “Middle-aged people, by contrast, may be more expensive to care for, but they’re also being charged considerably more for their policies. So healthy middle-aged people help balance out the risk pool just as younger people would.”
Opponents of the Affordable Care Act are still determined to consider the plan a failure, regardless. They complain that people may be able to continue enrolling even after deadline, or that they will be punished for not getting coverage, or, even more bizarrely, they are complaining because people won’t get penalized for not buying coverage. The biggest problem right now, it seems, is that the GOP has full action plans for what to do if Obamacare is a failure, but not how to react if it ends up being a success.
That latter issue is important, since midterm campaign season is fully underway. No one seems entirely certain whether the recent Florida congressional special election truly gave any indication of whether either party should run on or away from the ACA as a campaign issue, and there doesn’t seem to be a clear consensus if Obamacare is popular enough for Democrats to embrace or still oppose to the point that the GOP can use their opposition as a cudgel.
The confusion makes sense. Just like always, Obamacare seems to be publicly unpopular, despite the number of enrollees who are taking advantage. However, repealing it is more unpopular. Why? Because many of those who oppose it oppose it because they wish it went even further to help people, especially when it comes to bringing down insurance costs. No wonder the GOP likes to condemn the program but not offer up any real alternatives.
Whether or not the ACA is publicly lauded as a success, 7 million people are now insured who needed insurance because they either were not covered or didn’t receive enough coverage in their previous plans. Another projected 3 million young adults have been brought onto their parents’ coverage plans. Women are now able to access no copay birth control options without added out of pocket costs, and maternity care is a standard part of every qualified insurance plan. Americans will be far less likely to go bankrupt because of hospital costs, and many will be able to treat preventable conditions before they become medical catastrophes.
Was Obamacare’s open enrollment a success? To those people, it sure was.
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