Noise and Bluster
"We're only six days into June, and opponents of the ACA have already had a terrible month." ―Simon Maloy
After all the noise and bluster, it would seem that opponents of Obamacare are bound to be disappointed; for many of them, it would seem the individual mandate is working at least as well as they said it would when they supported the policy—
i.e., before a Democratic president agreed with them.
As
Steve Benen suggests, "The news surrounding the Affordable Care Act has been so good this week, it's almost hard to know where to start."
We could start with the fact that private insurers who skipped the exchanges now want in ...
One of the many, many, many predictions of Obamacare failure made by conservatives is that insurance companies would systematically drop out of the exchanges. They made this prediction many, many, many, many, many times. The data is starting to come in and, guess what, insurance companies are joining the exchanges. Dan Diamond reports that, in every state that has reported information so far, the number of insurance companies competing in the exchanges will expand in year two.
... or we could go with the fact, as expected, consumers are paying their premiums ...
I'm quite confident that at least 90% of the original 8.02 million exchange QHP enrollees have paid their first premiums (and I'm guessing up to 80% of the 300K+ who've enrolled since then).
... or we could talk about “Obamacare” cutting the rate of uninsured in New Jersey by 38%, Minnesota by 40%, and Kentucky by 50%.
By why stop there?
Indeed; there are the data coming in from Medicare, and also polling numbers suggesting people prefer repair of the law's quirks and shortcomings over repeal of the entire package.
Simon Maloy of Salon considers some of the political implications:
The big news was the release of new data from the White House indicating that enrollment in Medicaid has surged in states that elected to expand the program under the Affordable Care Act. In April alone more than 1 million people signed up for coverage. Medicaid enrollment in states that rejected the expansion has also gone up as people who didn’t know they were eligible started signing up – the so-called Woodwork Effect. Add all those enrollees to the number of people who were on Medicaid or CHIP prior to the ACA’s implementation, and you come up with just over 65 million Americans enrolled in the program.
As Paul Waldman puts it at the Washington Post, this is game over for Republican critics of the law who insist on repealing and replacing the ACA to get government out of healthcare. To do so, they’d have to find a way to transition tens of millions of people off of their government-provided health coverage. “Even if Republicans took back the White House and both houses of Congress,” Waldman writes, “moving people off their government insurance would be next to impossible.” The fight over Obamacare was always going to be a war of attrition, and it was always stacked against the Republicans.
And it’s not just that people are signing up for Medicaid; they’re using it, and early indicators are that expanding access to healthcare is having the intended effect of reducing instances of uncompensated care. The Colorado Hospital Association released a study this week showing that “hospitals in states that chose to expand Medicaid under the Affordable Care Act saw significantly more Medicaid patients and a related reduction in self-pay and charity care cases.” Hospitals are obligated to treat and stabilize emergency room patients regardless of their insurance status or their ability to pay. If they can’t pay, the hospital gets stuck with the bill. Expanding the Medicaid rolls means that more people can seek out care and hospitals will have to absorb less bad debt, which could lead to lower healthcare costs overall.
The popularity of expanded Medicaid sets it apart from the rest of the ACA, which is still broadly disliked. That niche popularity has opened up a narrow path for Democrats to take the offensive on Obamacare and put pressure on Republicans who oppose the expansion. Senate Democrats sent a letter this week to Republican governors in states that rejected expanded Medicaid urging them to “put politics aside and do the right thing in helping to expand Medicaid coverage to the millions of Americans who desperately need it.” Among the signatories to that letter were Sens. Kay Hagan, Mary Landrieu and Mark Begich, all of whom are facing tough reelection fights this cycle.
One of the most interesting aspects of this particular thread has always been a coincidence observable among some of the PPACA's critics, who already believe that government screws everything up, but want us to believe that the troubled launch of the Healthcare.gov website is somehow exceptional, as if any other day govenrment would have done a fine job if it wasn't for those rascally Democrats screwing up.
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Notes:
Maloy, Simon. "GOP’s quiet Obamacare disaster: How this week’s biggest story got overlooked". Salon. June 6, 2014. Salon.com. June 14, 2014. http://www.salon.com/2014/06/06/gop..._how_this_weeks_biggest_story_got_overlooked/
Benen, Steve. "Everything’s coming up aces for the ACA". msnbc. June 13, 2014. msnbc.com. June 14, 2014. http://www.msnbc.com/rachel-maddow-show/everythings-coming-aces-the-aca
