Let the celebration commence, America. The Obama administration surpassed the seven million exchange "enrollment" mark as of last night, thus fulfilling the goal they originally set for themselves, then abandoned, then re-embraced. Of course, the "official" number isn't accurate, for reasons we've beaten to death around here: It doesn't factor in non-payments, nor does it account for those who previously had insurance. Health experts, and even Kathleen Sebelius, have indicated that the national payment delinquency rate is in the neighborhood of 20 percent, so even if HHS hits the seven million tally, you can knock nearly a million-and-a-half "enrollees" right off the top. As for the percentage of the newly insured who truly didn't have prior coverage, those stats are unclear -- but three independent studies peg the number somewhere between 25 and 33 percent:
7 million - 20% non-payment rate = 5.6 million, 66 to 75% of whom previously had coverage.— Guy Benson (@guypbenson) April 1, 2014
We also don't know how many of this pool are young, healthy consumers, a critical factor. Nevertheless, prepare for a giddy round of self-congratulation on the Left, with declarations of vindication and victory. Let them have their moment while it lasts. Let's also recognize that some people have been helped by Obamacare, and it's okay to be happy for them. The problem Democrats will continue to run into in the coming months, though, is that millions of people have been actively harmed by the law through dropped coverage, restricted access and higher costs. Democrats sold Obamacare as a veritable panacea, featuring no losers, no trade-offs, no downsides. And the pain is just getting started:
As procrastinators rushed to purchase health insurance Monday by the Affordable Care Act’s official enrollment deadline, new research estimates that about half of those with subsidized coverage obtained from federal or state marketplaces will lose it within a year because of changes in their incomes or other family circumstances, such as divorce, relocation or the births of children. The same is true for about half of new Medicaid recipients, who are likely to lose program eligibility at some point over the next year for a variety of reasons, said Benjamin Sommers, an assistant professor of health policy and economics at the Harvard School of Public Health. When people lose, drop or change health coverage for unforeseen reasons, it’s known as “churning.” It’s a common occurrence for consumers with individual coverage purchased outside the workplace, as well as for those with Medicaid, the state-federal health program for poor people and those with disabilities.
And that's just the tumult among those who obtained subsidized plans through Obamacare exchanges. Millions of additional Americans are expected to lose their existing coverage, many from within the small group market, because of Obamacare. That's the second wave of cancellations (of several) we've been warning about for months. Internal White House projections estimated that as many as 93 million Americans would lose their existing coverage before all is said and done. Then there are the steep premium increases, which industry experts say are coming. The administration is conceding this point, but feebly arguing that the spikes will be relatively small -- a point disputed by insurance sources. Another respected health industry official estimates that monthly payments will increase for roughly three-quarters of consumers, which doesn't even address higher out-of-pocket costs. The Associated Press notes that rural voters are being hit especially hard:
The rural-urban cost divide has been exacerbated by the Affordable Care Act....It's a bumpy confrontation for many in rural areas who earn too much to qualify for premium subsidies but not enough to easily afford premiums that can approach or exceed $1,000 a month. "I have people mad enough to bite a nail in half down here, saying, 'Why are my prices so high?'" said David Hardin, an insurance broker in the southwest Georgia community of Albany, in another of the nation's priciest private health insurance zones. "Either they're mad as all get-out, or I can hear them crying on the phone. It just breaks your heart," said Hardin, whose customers are seeing monthly premiums that cost at least $500 a month more than if they'd lived in Atlanta. "I think there was the idea that it might reduce costs, and now they're seeing that it's not."
So as the champagne corks pop at 1600 Pennsylvania Avenue, remember that many more Americans will confront their own Obamacare hardships in the months and years ahead:
Bob Laszewski believes there's still a way to salvage Obamacare by making some significant changes -- stat. How likely are Democrats to take his advice? Not likely, I'd say, given that the chairwoman for the "fix, don't repeal" party can't think of a single fix she'd make off the top of her head.