With so much of the media's attention fixated on Obamacare's technological meltdown, some important storylines have gone under-explored. CBS news, to its credit delved into one of them today, noting that of the people who have successfully obtained coverage under the new law, it appears that the vast majority of them are new Medicaid enrollees. And that poses a mortal threat to the entire structure of the law:
The disastrous rollout of HealthCare.gov may have another serious problem: A CBS News analysis shows that in many of the 15 state-based health insurance exchanges more people are enrolling in Medicaid rather than buying private health insurance. And if that trend continues, there's concern there won't be enough healthy people buying health insurance for the system to work...The newly insured in some of those states are overwhelmingly low-income people signing up for Medicaid at no cost to them. Matt Salo, executive director of the National Association of Medicaid Directors, said, "We're seeing a huge spike in terms of Medicaid enrollments." He says the numbers have surprised him and state officials. CBS News has confirmed that in Washington, of the more than 35,000 people newly enrolled, 87 percent signed up for Medicaid. In Kentucky, out of 26,000 new enrollments, 82 percent are in Medicaid. And in New York, of 37,000 enrollments, Medicaid accounts for 64 percent...Gail Wilensky, a former Medicaid director, said the numbers are causing concern in the insurance industry, which needs healthy adults to buy private insurance in large numbers for the system to work. "Either the private insurance enrollments come up somewhere around the expected amount or there's going to be a problem. ... You need a volume and you need a mix of people that are healthy as well as high users in private insurance, in order to have it be sustainable," she said.
Those stats from Washington, Kentucky and New York are hugely problematic. The poor and sick are managing to sign up for Medicaid -- to the "surprise" of state officials -- but they aren't been offset by people who are actually purchasing care. Another crucial point: Medicaid was already in very poor fiscal and functional condition before Obamacare extended it massively. It's terribly underfunded; many doctors and hospitals refuse to accept new Medicaid patients due to the government's paltry reimbursement rates. Perhaps worst of all, Medicaid is catastrophically ineffective. Just because indigent individuals are enrolled in Medcaid coverage doesn't mean they actually receive quality care. According to the most comprehensive study ever done on the program (which used Oregon's system as the basis for analysis) poor people enrolled in Medicaid have no better health outcomes than their uninsured counterparts. We're not just spending endless billions on a program that flat-out doesn't work, we're expanding it through Obamacare. This is why the president isn't being truthful when he claims that apart from the website, the underlying Obamacare product is "good" and working "really well." It's not. We touched on the issue of dropped coverage yesterday, another one of the law's glaring flaws and broken promises. CBS News is on that case, too:
The Affordable Care Act was signed by President Obama in 2010 and since then he has repeated one reassuring phrase: "If you like your insurance plan you will keep it. No one will be able to take that away from you. It hasn't happened yet. It won't happen in the future." But it is happening..."I was completely happy with the insurance I had before," Willes said. So she was surprised when she tried to renew her policy. What did she find out? "That my insurance was going to be completely different, and they were going to be replaced with 10 new plans that were going to fall under the regulations of the Affordable Care Act," she said. "Before I had a plan that I had a $1,500 deductible," she said. "I paid $199 dollars a month. The most similar plan that I would have available to me would be $278 a month. My deductible would be $6,500 dollars, and all of my care after that point would only be covered 70 percent."
Shorter CBS: The president lied. In the case of this young woman, Ed Morrissey runs the math: "Willes will have to pay $948 more a year for the new policy, but that’s not all. She will also have to another $5,000 extra on top of that to get past the deductible each year before she gets any benefit from the policy at all." Her plan is being dropped, her out-of-pocket costs are quadrupling, and her premiums are nearly doubling -- a parade of shattered promises. It's outrageous. Ms. Willes is not the only person who's going to end up paying a lot more. Obamacare supporter Kirsten Powers admitted on Fox News last night that her costs are jumping considerably because of the new law:
Give Powers a few points for intellectual honesty. She admits that her own plan is getting approximately twice as expensive, then slaps the White House for selling Obama's multi-trillion-dollar overhaul on false pretenses. Meanwhile, ten Senate Democrats are calling on the administration to delay and extend the enrollment -- which would accelerate the death spiral (for reasons explained here), and would be illegal as a unilateral executive decree. These Democrats think they're sounding reasonable and buying time, when in fact they're doing neither. I'll say it again: If panicked Democrats genuinely believe their program is so unready in its current state that it must be pushed back, the only way they can stave off disaster is a delay of pretty much the entire law. Will Harry Reid allow such a vote? Up-or-down. Time's a-wastin'. The administration's "tech surge" guru is now claiming that healthcare.gov will be fully functional by the end of November. That time frame will likely stir skepticism among various experts, who've estimated the project will last months. The White House's own deadline has jumped from October 1 to November 30. If the new goal isn't met, major, disruptive delays are going to be unavoidable. I'll leave you with NBC's David Gregory wondering if Republicans have been right about Obamacare all along: