In January, we reported that the nonpartisan Congressional Budget Office had downgraded its forecast for Obamacare enrollments by eight million people, with many consumers deciding that the 'Affordable' Care Act was just too costly. The official protections were slashed by another million in March. Among the millions of Americans who have signed up for the law since 2013, a large percentage of them were covered before the law evicted them from their existing plans, in contravention of a central presidential promise. By one important measure, Obamacare's overall enrollment performance has undershot initial actuarial forecasts by 24 million people. And as taxpayers shell out $2 trillion to pay for a failing, unpopular law, CBO has also determined that the number of uninsured Americans is expected to rise from 26 million to 28 million between 2017 and 2026.
Pro-Obamacare forces have more or less abandoned their own sales pitch on the law -- including on cost curves, allowing people to maintain satisfactory arrangements, "choice and competition," enhanced access, and especially affordability. Instead, they've planted their flag on "more people are insured thanks to this law," which is a woefully insufficient metric for success. Of course more individuals will obtain coverage when they're legally required to do so, and when taxpayers are spending waterfalls of money to subsidize those purchases. The bigger story is how few people have done so, and how that dearth of participation is threatening the very foundation of the law. The Washington Post noted recently that sign-ups remain "far short" of initial expectations:
Enrollment in the insurance exchanges for President Obama’s signature health-care law is at less than half the initial forecast, pushing several major insurance companies to stop offering health plans in certain markets because of significant financial losses. As a result, the administration’s promise of a menu of health-plan choices has been replaced by a grim, though preliminary, forecast: Next year, more than 1 in 4 counties are at risk of having a single insurer on its exchange, said Cynthia Cox, who studies health reform for the Kaiser Family Foundation. Debate over how perilous the predicament is for the Affordable Care Act, commonly called Obamacare, is nearly as partisan as the divide over the law itself. But at the root of the problem is this: The success of the law depends fundamentally on the exchanges being profitable for insurers — and that requires more people to sign up. In February 2013, the Congressional Budget Office predicted that 24 million people would buy health coverage through the federally and state-operated online exchanges by this year. Just 11.1 million people were signed up as of late March.
...The law requires every American to get health coverage or pay a penalty, but the penalty hasn’t been high enough to persuade many Americans to buy into the health plans. Even those who qualify for subsidized premiums sometimes balk at the high deductibles on some plans. People who do outreach to the uninsured say the enrollment process itself has been more complex and confusing than Obama’s initial comparison to buying a plane ticket. “This exchange will allow you to one-stop shop for a health-care plan, compare benefits and prices, and choose a plan that’s best for you and your family,” Obama said in a speech in 2009. “You will have your choice of a number of plans that offer a few different packages, but every plan would offer an affordable, basic package.” In some markets, a shortfall in enrollment is testing insurers’ ability to balance the medical claims they pay out with income from premiums. In an announcement curtailing its involvement in the exchanges this month, Aetna cited financial losses traced to too many sick people signing up for care and not enough healthy ones.
When you sell an 'everybody wins' paradise wherein everything is simple and cheap and wonderful, disillusionment can set in very quickly if your words don't mark reality. That's what's happening: Obama's signature domestic "accomplishment" is failing badly because its critics were correct about nearly everything, and because (a) his vaunted rhetorical skills failed to convince most Americans that his plan was a good idea from the beginning, and (b) his assurances have been systematically exposed as fantastical snake oil as reality sets in. The Post story cites a Kaiser Foundation estimate that approximately one in four US counties "are at risk of having a single insurer on its exchange" next year. Avelere, a top health care consulting firm, expects that number to eclipse one-third of regions:
Here is a summary package from Fox News' Special Report on Obamacare's latest struggles:
The White House and Obamacare Godmother Hillary Clinton continue to assert that the law is working, even as they're discussing and proposing costly and destructive "fixes" to the law, perhaps spurred on by the urgency of an explosion of reports from media outlets that are beginning to realize that Obamacare is in serious trouble. Congressional Republicans have voted to repeal the law, a move thwarted by the president. They've also released a detailed replacement proposal that one analysis says would substantially lower costs for individuals and families, as well as the federal government, without massively disrupting the percentage of Americans covered.