The Only Obamacare Number That Matters
The monthly announcement of Obamacare's enrollment figures has become an exercise in confirmation bias, starting with the administration itself. Health and Human Services Secretary Kathleen Sebelius noted the "encouraging trends" in yesterday's release, while House Speaker John Boehner opted to highlight its "embarrassing failures."
With just two months to go before the end of the Affordable Care Act's open-enrollment period, this kind of back-and-forth is a partisan indulgence. What matters is whether the law is helping more Americans get affordable health insurance -- a goal all sides claim to support.
On that score, more than 1.1 million people signed up for insurance coverage on the law's state exchanges last month, bringing total enrollment to 3.3 million. That's the good news, and about halfway to the government's initial projections of covering 7 million Americans by the end of March.
On the other hand, not enough of these new customers are young and healthy, and it's unclear how many of those gaining coverage didn’t have it before.
Why does this matter? Because younger enrollees are cheaper, and they help balance the risk pool. One-quarter of new enrollees are ages 18 to 34, below the 40 percent threshold the administration at first said was necessary to keep premiums steady. Moreover, 55 percent of enrollees are women, who are generally more expensive to insure than men, mostly because of maternity care.
The only debate worth having is how to improve enrollment. If not enough people sign up, or the mix of beneficiaries isn’t quite right, it could lead to higher premiums down the road, pushing people away from buying coverage and making the law less effective.
In other words, what matters now is how to persuade more young people, especially young men, to sign up for health insurance before March 31. What has the administration learned in the first fourth months of open enrollment? What works and what doesn't? Everything else is beside the point.
The administration is already pushing hard, and its efforts have come in for a fair amount of ridicule: ads featuring cats, for example, to get more women to sign up, and the much-maligned "pajama boy," whose appeal was to … actually it’s not clear who he was trying to appeal to. At any rate, a little ridicule is a small price to pay if these attempts result in higher enrollment. Republican state officials might also do more to promote the law, futile as it may be to point that out.
Contrary to what you may have read, enrollment numbers for Obamacare aren’t some referendum on the president's popularity or lack thereof. They’re the best way to tell whether the law is working as planned -- and how to adjust if it isn't.
To contact the editor responsible for this article: David Shipley at firstname.lastname@example.org.