The good and bad news for Obamacare in new data
A stream of new data has been released in the last several days about the new health care law and its impact. Here are five key numbers that tell the story:
1. 4.2 million
The U.S. government announced on Tuesday that 4.2 million Americans have enrolled in private health care plans since Oct 1st under the new law. Even if a flood of Americans sign up over the next month, that number is unlikely to reach 7 million, which was the original estimate for how many people would get insurance during the first year of Obamacare.
Politically, this is a problem for the Obama administration, as Republicans can cast the law as falling short of expectations. The Congressional Budget Office has already suggested that part of the reason people have not enrolled at the expected pace was the flawed rollout of the law’s website in the fall.
In terms of the the actual goals of the law, this 7 million number is less important. The CBO has estimated by 2017 that 24 million Americans will be enrolled in insurance through these health care exchanges through a gradual build-up, with substantial increases each year. In that context, having 6 million people enrolled, instead of 7 million, because of website challenges in the first year is not a huge problem.
What we don’t know is if the website is the entire reason for people not enrolling. Some data suggests that, particularly in less populous counties where only one or two insurer companies are operating, that the prices for the insurance are higher than people expect and that’s what keeping them from purchasing a plan.
If people don’t want the health insurance because it’s priced too high, that is a major issue.
2. 4.2 million again
This number tells you LESS than you think at first glance. The administration does not separate out people who had insurance in 2013 through another means but are now getting it on one of the government-operated websites versus people who were truly uninsured before Obamacare. Surveys suggest a sizable number of people who are getting insurance already had it last year, so it’s not the case that 4.2 million are newly insured through the health care exchange.
At the same time, millions of people have enrolled in expanded Medicaid over the last few months, although again so far government data includes both new enrollments and people who were in the program in 2013 and signed up again.
It’s likely that more than 4 million people are newly-insured because of some part of Obamacare, but it’s really hard to break those numbers down with the current data.
3. 25 percent
That’s the percentage of people between ages 18 and 34 who are enrolled in the new exchanges, far short of the 38 percent the White House said it hoped for last year. This the clearest, most obvious problem with the implementation of the law right now.
Ideally, since people between ages 18-34 are about 40 percent of the uninsured, they would be about 40 percent of the Americans enrolling in new health insurance. And Obamacare is designed to work in part by having older Americans, who tend to be sicker, effectively subsidized by younger, healthier people.
That gap is why President Obama is doing anything he can to reach younger Americans, such as appearing in an clever web video that went viral on Tuesday. Again, it’s not precisely clear why young Americans are not signing up in larger numbers, price, insufficient information or a lack of desire to get health insurance.
It’s not unclear exactly what will happen if 25-30 percent of the people enrolled in the health care exchanges, instead of 40 percent. Insurance companies could decide to raise rates significantly higher than last year, arguing they are getting sicker, older patients than anticipated. Or, their rates could remain similar to this year’s, if the insurance companies were less optimistic than the Obama administration about young Americans enrolling in the first place.
4. $95 or 1 percent of your income
President Obama and his team so far have not emphasized one reason that Americans should get insurance: it’s the law. Under “Obamacare,” people who don’t purchase insurance face a fine of either $95 or 1 percent of their taxable income, whichever number is higher. There are exemptions to this policy, but one of the ways the law was designed to get young, healthy people to buy insurance was forcing them to.
It will be interesting to see if, in the days before March 31, the president and his team make this point. The mandate is perhaps the most unpopular part of the law, but highlighting this tax for being uninsured could spur more people to enroll.
To enroll in the new health care law, it’s not necessary to say if you already have health insurance and are just getting a different plan or if you were truly uninsured before. Surveys say such a sizable number of Americans who had health insurance last year are simply getting different courage through Obamacare. So some of that 4.2 million are not newly-insured people.
At the same time, the law dramatically expands Medicaid as well.