President Barack Obama’s declaration that 7.1 million health-plan enrollments serve as a rebuke to critics of his signature law won’t diminish the opposition nor stop the scrutiny of the overhaul’s effect.
“The Affordable Care Act hasn’t completely fixed our long-broken health-care system, but this law has made our health-care system a lot better,” Obama told administration officials, lawmakers and other supporters in the White House Rose Garden. “The debate over repealing this law is over.”
The enrollment figure is a symbolic achievement for the president, matching initial estimates by the Congressional Budget Office that his administration adopted as a goal before new insurance exchanges opened Oct. 1. In February, after the marketplaces experienced widespread computer errors, preventing many people from signing up until December, the CBO scaled back its estimate to 6 million. That number was reached by March 27.
The total announced by Obama doesn’t reflect all enrollment from 14 separate state exchanges on the final day or people who started the process and weren’t able to finish because of technical difficulties. Republicans said the figure lacks credibility because it doesn’t account for people who never pay their first premium to their insurers, the final step required to enroll. While the law sought to provide health-care coverage to the uninsured, it’s not clear how many people who enrolled through the exchanges already had a health plan.
“These numbers are a total fantasy -- they’re arbitrary and fictitious,” Representative Michael Burgess, a Texas Republican, said in a statement yesterday that was typical of the reaction from his party.
Obama said that Republicans have criticized the law “without offering any plausible alternative.” Since 2011, the House of Representatives under Republican control has voted 55 times to repeal parts or all of the 2010 Patient Protection and Affordable Care Act, known as Obamacare, and has never passed legislation to comparably expand U.S. health insurance coverage.
Republicans plan to make dissatisfaction with Obamacare a central plank in November’s congressional elections. A Washington Post/ABC poll of 1,017 Americans released yesterday found that 49 percent support the law and 48 percent oppose it.
The proportion of uninsured Americans has fallen since January, when exchange coverage began and Medicaid was expanded in about half the states to cover more adults earning close to poverty wages. About 15.9 percent of U.S. residents lacked insurance in the first quarter of 2014, according to a Gallup Inc. survey, the lowest quarterly level since 2008.
Even so, about 45 million people in the U.S. are expected to be without insurance this year, the CBO said in February. Even 11 years after the law’s expansion of coverage, the number of uninsured is projected at 31 million, the CBO said.
Republican Representative Paul Ryan of Wisconsin called yesterday’s enrollment figures “a Pyrrhic victory.” His party intends to offer legislation to replace the Affordable Care Act, he said yesterday as he introduced a budget that would cut federal spending on Medicaid, the state-run health program for the poor.
While reaching 7 million enrollees represented a political victory for the president, it may not turn around his second-term fortunes. Democrats remain at risk of losing control of the Senate in November. The president’s approval ratings are stuck in the 40s, with Gallup’s latest three-day tracking poll showing 44 percent of Americans approve of his performance while 51 percent disapprove.
House Minority Leader Nancy Pelosi said Democrats “are very pleased with the ACA results,” and the party’s candidates won’t be running from the issue.
“Overwhelmingly, our members are out there on the offensive on this,” the California Democrat said, speaking yesterday at the White House after meeting with Obama.
Senior administration officials who briefed reporters before Obama’s remarks, on condition that they not be identified, said Democrats who embrace the law will be able to mobilize the coalition of voters who twice elected the president.
Attention also will turn to the quality of coverage Obamacare enrollees receive, their access to medical services, and insurer preparations for 2015.
Indianapolis-based WellPoint Inc., the largest exchange insurer, has warned it may propose “double-digit plus” premium increases for the next enrollment period, which begins in November. Insurers must quickly assess the medical demands of their new customers before filing rates at the end of May.
“If policy changes encourage fewer young and healthier people to purchase coverage in the exchange, premiums will increase in the marketplace and there will be fewer choices for consumers,” America’s Health Insurance Plans, the industry’s Washington lobby group, said in a statement on its website yesterday.
The group also said the government should limit the amount of time people have to complete their enrollment, if they didn’t make the March 31 deadline.