The number of uninsured Americans has declined since the passage of ObamaCare. That much is conceded by supporters and critics of the law. But beyond that simple statement, there is much disagreement.
Critics have noted that the increase in the rolls of the insured has been about 70% Medicaid expansion and 30% private insurance. Most of the newly privately insured enrolled on the insurance exchanges where they received generous government subsidies, but now face daunting deductibles that average over $6000 per year.
Supporters have recently swooned with reports that greatly exaggerate ObamaCare’s success. One recent headline blushed “After ObamaCare Number of Uninsured Hits Five Year Low.” Another concerned the results of the National Health Interview Survey, which found that 7 million fewer people were uninsured in the first three months of 2015 compared to the average for all of 2014.
Several liberal media outlets including CQ HealthBeat, The Hill, and The Huffington Post reported 16 million fewer uninsured – and gave credit to ObamaCare for this improvement. Are these reports true and is it correct to give the credit to ObamaCare?
“Insurance coverage has increased across all types of insurance since the major provisions of the federal Affordable Care Act took effect, with a net total of 16.9 million people becoming newly enrolled through February 2015. Researchers estimate that from September 2013 to February 2015, 22.8 million Americans became newly insured and 5.9 million lost coverage, for a net of 16.9 million newly insured Americans. Among those newly gaining coverage, 9.6 million people enrolled in employer-sponsored health plans, followed by Medicaid (6.5 million), the individual marketplaces (4.1 million), non marketplace individual plans (1.2 million) and other insurance sources (1.5 million).
Laszewski analyzes this report by noting that more than half of the reduction in the number of people who are uninsured is coming from an old fashioned increase in the number of people with employer health plans. Since the Employer Mandate of ObamaCare was delayed in 2014, this rise cannot be attributed to ObamaCare. Nor is there much evidence that the Individual Mandate, which has been weakly enforced, has had any significant impact on enrollment of individuals. He believes this increase is largely due to the recovering economy and lower unemployment.
Also, the individual marketplaces created by ObamaCare account for only 4.1 million newly enrolled; much less than anticipated by the Obama administration. In fact, only about 40 % of those eligible for the ObamaCare insurance exchanges have actually signed up. This leaves enrollment far behind the CBO estimates of 13 million for 2015.
Most of those who have enrolled are people with very low incomes who are paying the lowest premiums and getting the most in subsidies. This fact was graphically displayed in an earlier post, The Affordable Care Act Is Unaffordable.
This brings us to the conclusion, once again, that ObamaCare is mostly an expansion of Medicaid. The largest ObamaCare gains in enrollment come from Medicaid, a program that is free in the states that chose to expand it under ObamaCare.
Another misleading report widely disseminated last week stated that 943, 934 new enrollees signed up since open enrollment ended on February 22, through the “special enrollment periods (SEPs).” SEPs are for people newly eligible after the close of the open enrollment because of status changes such as divorce or loss of a job.
Stephanie Armour of The Wall Street Journal correctly noted that earlier reports of enrollment by the government said, “ 8.8 million selected a plan or were re-enrolled through HealthCare.gov during the open enrollment this year. As of March 31, 7.5 million had coverage and paid premiums.” Simply doing the math it is evident that 1.3 million people fell off the rolls while 943,934 were added. That’s a net loss of 356,066 enrollees.
Furthermore, the Obama administration has not given us any updated numbers since March 31st. Laszewski says that insurance plans usually see an attrition rate of 2% per month. That means in the six months since their last reporting, there have probably been about 800,000 more lost to enrollment.
Laszewski gives us the bottom line: “The ObamaCare insurance exchanges aren’t enrolling anywhere near the number of people they were supposed to. And, there is no proof ObamaCare has grown since the close of open enrollment. In fact the anecdotal and historical evidence would suggest it is now shrinking. But we really don’t know because the Obama administration is just reporting the good news and a good share of the press appears to be happy to pass these numbers along – albeit in a technically correct but hardly complete way.”
In other words, the “most transparent administration in history,” to use Obama’s favorite description, continues to keep the truth from the American people.