The Latest Numbers Are In
According to the latest official figures, about 9 MILLION Americans have received health coverage through various provisions of the Affordable Care Act, including:
- 2.2 MILLION who purchased private health plans through the federal and state marketplaces between October 1 and December 31
- 3.9 MILLION Americans who were found to be eligible for Medicaid or the Children’s Health Insurance Program (CHIP)
- 3 MILLION or so young people who have been able to stay on their parents’ health plans until their 26th birthdays
Other Americans have also purchased plans directly from insurers, but the government doesn’t yet have data on those individuals. It’s also worth remembering that another 4.8 MILLION low-income Americans who could have received Medicaid coverage won’t receive any coverage at all because Republican governors and state legislators are refusing to expand Medicaid.
The other important information we received yesterday was the breakdown of those buying private insurance by age. In order for the system to work properly, the influx of older and sicker people who are now flocking to the system after finding it difficult or impossible to find or afford coverage before need to be balanced out by younger, healthier people.
Right now about 24 percent of the new pool of enrollees is part of the latter group, which is right about where experts believe it has to be in order to avoid sizable premium increases as a result of an unbalanced pool. The nonpartisan Kaiser Family Foundation called the figures “encouraging” and the Washington Post’s Ezra Klein declared the end of fears that a so-called “death spiral” would occur in the new marketplaces:
The risk of a “death spiral” is over. The Kaiser Family Foundation estimates that if the market’s age distribution freezes at its current level — an extremely unlikely scenario — “overall costs in individual market plans would be about 2.4% higher than premium revenues.” So, in theory, premiums costs might rise by a few percentage points. That’s a problem, but it’s nothing even in the neighborhood of a death spiral.
Here are a few reasons to be encouraged by how enrollment is proceeding:
- The pace of enrollment in the Affordable Care Act’s marketplaces is looking very similar to what happened during Massachusetts’ successful rollout in 2007.
- The problems with HealthCare.gov prevented or deterred many people from enrolling during October and November, but now that the website is working enrollment is surging, particularly among young people.
- Campaigns to drive enrollment among young people and others had to be put on hold when HealthCare.gov was not working, but now those efforts are getting underway in earnest.
- By their very nature, young people are procrastinators and are more likely to wait until closer to the March 31 deadline to enroll.
It’s also worth noting that the Affordable Care Act includes built-in mechanisms to stabilize premiums over the first few years if the mix of new enrollees isn’t exactly what insurers anticipate it will be. Naturally, Republicans in Congress are specifically trying to repeal those provisions, which could conveniently result in premium increases that would be announced just before this year’s elections.
For their part, Republicans are once again declaring the law a failure because of the number of young people who have signed up so far. As Kevin Drum of Mother Jones wrote today, the law is doing just fine and it’s probably best just to start ignoring their neverending series of false and misleading attacks:
Republicans are trying to make hay with this, but that’s just Republicans being Republicans. You can safely ignore them. There’s really nothing much to worry about here.
BOTTOM LINE: The Affordable Care Act is here, here to stay and it’s working. While much work remains to be done over the next few months (and years) to fully implement the law, its partisan critics are wrong — as the millions of Americans who now have quality, affordable health coverage thanks to the law can attest.
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