ObamaCare’s Winners: 3.4 Million, Not 26 Million

This comes from the Daily Signal.

The runaround continues at the White House.
 

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In April, President Obama told the nation that “marketplace” or “exchange” enrollment, at 8 million customers as of March 31, had exceeded expectations and costs were lower than expected.

Many in the news media accepted the selectively released statistics, despite the Obama administration’s record of sometimes providing inaccurate or incomplete information on HealthCare.gov. Even today, the government continues to withhold relevant public information on costs and enrollment requested by Congress and the press under the Freedom of Information Act. . . .

Many who were considered uninsurable now have affordable policies. But the Affordable Care Act has shifted the cost burden for those who already had insurance. More policies now have bigger deductibles and cost more.

Key questions include:

How many actually have enrolled?
How many of those were previously uninsured?
How has Obamacare affected the overall pool of uninsured?
What percentage of eligible people have signed up?
What’s the cost?

Enrollment: Less Than Advertised

The administration hasn’t released any enrollment figures in the last 2 ½ months, and a spokesman from the government’s Centers for Medicare and Medicaid Services, which helps oversee Obamacare, said the agency is not likely to issue any updates soon. . . .

As of March 31, according to the Obama administration, 8 million people signed up for private insurance in the Health Insurance Marketplace, exceeding its target of 7 million. . . .

But the 8 million figure is overstated because it counted people who weren’t actually covered because they hadn’t paid their premiums, which Blue Cross, analysts and the government agree is in the 15 percent to 20 percent range.

Therefore, the actual number of Obamacare enrollees as of March 31 was likely between 6.4 million and 6.8 million, below both the administration’s figure of 8 million and its stated target of 7 million.

Obamacare enrollment wasn’t 8 million because up to 20 percent didn’t pay their premiums.

Nobody from the White House responded to repeated requests for comment. A spokesman for CMS said there were no plans to release figures on paid enrollment, even though health policy analyst Robert Laszewski says the administration could provide the number in days or even hours if it wanted to. . . .

Estimates of how many marketplace enrollees were previously uninsured range from about one-third to more than half, depending on the survey and the methods used.

A recent Kaiser Family Foundation survey found that 43 percent of those who purchased insurance through the marketplace already had insurance; 57 percent are newly insured. . . .

Assuming the most positive estimates—that 85 percent of the 8 million enrollees have paid their premiums and 43 percent had coverage before—the newly insured would number only about 3.9 million. By this time, CBO had projected 19 million would have been removed from the ranks of the uninsured, and CMS predicted 26 million. . . .

Many enrollees were gained due to “coverage substitution,” according to health care policy expert Edmund Haislmaier of The Heritage Foundation, which publishes The Daily Signal.

Haislmaier, who testified before the House Committee on Oversight and Government Reform earlier this month, said this means that people who had insurance then substituted what they had for new coverage with more in the way of subsidy dollars. . . .

“If you’ve got coverage now and a government program offers a replacement with more subsidies, then you’re going to have an incentive to move to that,” Haislmaier explains. “No doubt it helps people by helping them buy something that they already had. … But it isn’t a net increase.”

Meanwhile, some who were forced out of their existing coverage but not eligible for subsidies found themselves having to re-enroll at much higher rates than before, said Laszewski.

“It was not uncommon to see [insurers] increase their [rates] by 35 percent to bring policies into compliance with Obamacare,” Laszewski said. “So, they have the same relatively healthy people with perhaps more benefits but for 35 percent more premium. That may be good news for the insurance companies but not for the individuals who are forced to pay more than a third more.”

Research from RAND Corp. shows 9.3 million more people had insurance in March 2014 than did in September 2013, and a recent Gallup poll puts the uninsured rate at its lowest level since 2008. The percentage of adults who don’t have insurance has dropped from 20.5 percent to 15.8 percent in the last year.

But it’s unclear how much of the drop can be credited to Obamacare and how much to other factors, such as changes to Medicaid enrollment. RAND’s study and another from the Urban Institute Health Policy Center both found fewer than half of the newly-insured gained coverage through the Obamacare exchanges.

Medicaid Enrollment

To date, it’s been the dramatic expansion of Medicaid under the Affordable Care Act that has reduced the ranks of the uninsured far more than the exchanges or HealthCare.gov. Medicaid, state-provided health insurance for the poor, is now available to those who earn up to 138 percent of the federal poverty line.

CMS estimates Medicaid will get 8.6 million new enrollees in 2014, thanks to Obamacare. Twenty-six states have expanded Medicaid, but if all did, spending by states would increase 26 percent—or $952 billion—from 2013 to 2022.

Where will the money come from to fund such an expansion? The federal government is paying 100 percent of the Medicaid extra benefit cost for the first three years. Then, 10 percent of the cost will transfer gradually back to the states, which already are under tremendous budget pressure. . . .

At this point, the CBO figuratively threw its hands in the air and stated that it no longer can figure the overall financial impact of the Affordable Care Act because it no longer can “determine exactly how the provisions of the ACA that are not related to the expansion of health insurance coverage have affected their projections of direct spending and revenues.”

That’s a big blow to the ability to track actual Obamacare effects on the federal budget and compare them to the original CBO estimate in 2010 that the health care law would reduce the deficit by more than $120 billion over a decade. . . .

Avalere, a health care advisory group, looked at nine states and found premium increases this year of 2.5 percent to 16 percent.

Laszewski, whose predictions have proven uncannily accurate, estimates the average cost of premiums for Americans will go up 9.9 percent next year, or just under the threshold that triggers a regulatory review under federal guidelines. . . .

Today, Americans’ satisfaction with the Affordable Care Act is mixed. A recent Gallup survey found 51 percent of respondents disapprove of the health care law. Only 43 percent approve.

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