By J.D. Heyes
In early April, President Obama wasted no time in taking a victory lap of sorts regarding the alleged success of his signature piece of legislation, the Affordable Care Act.
According to the president, the magic number of 7 million enrollees had finally been reached, six months after the rocky roll-out of the online federal health exchange that was established by the law. Actually, the president said, the number was closer to 7.1 million, and the country was told that the bulk of them “waited until the last minute” to sign up.
“The debate over repealing this law is over,” Obama declared to the press April 1, as if he now controls the legislative agenda of a Congress elected by the people. “The Affordable Care Act is here to stay.”
That sounded a lot like wishful thinking when the president made his declaration; now a pair of new studies proves that it certainly was.
As noted by The Fiscal Times:
Before we get to these studies, though, we should recognize why we need outside organizations to validate White House claims in the first place. The Department of Health and Human Services still has no way to quantify important data about those consumers signing up for health insurance through state and federal exchanges.
More than six months after the initial rollout of Obamacare — and four years after the ACA’s passage — the systems designed by HHS still cannot determine basic and critical information about enrollments such as whether a premium payment has been made. Without a premium payment, a sign-up in the web portal does not mean coverage has been extended.
Too few ‘young invincibles’
Also, the news site noted, the websites were not designed to even collect important demographic data like which enrollees had pre-existing health insurance coverage, as well as definite age ranges, despite the fact that the success of the law’s structure depends on getting previously uninsured and healthy Americans to become locked into expensive comprehensive, government-mandated insurance plans.
For example, without “young invincible” enrollees providing lots of new funding for risk pools that are now required to cover older, less-healthy Americans under “community pricing” restrictions, premiums are climbing rapidly, which will force even more consumers out of the system and trigger the feared “death spiral” for insurers.
So, to make it possible to determine the scope of Obama’s victory lap, outside surveys are necessary in order to paint a picture of the size and composition of the actual enrollee population. And the first of these has come from the RAND Corporation, a think tank that has examined changes in the health insurance market between September 2013 — just before the October 1 roll-out of the online federal and state exchanges — and the open-enrollment period at the end of March.
More from The Fiscal Times:
While the White House can claim credit for a net increase of 9.3 million insured and a lowered uninsured rate from 20.5 percent to 15.8 percent, the data provides a significantly different picture than that painted by President Obama and the ACA’s advocates.
Less equals more
For one, a significant amount of the increase comes from Americans enrolling in Medicaid — not private health insurance. Some 6 million people enrolled in the taxpayer-funded program; earlier studies found that a relatively small number of those came from the expansion built into Obamacare. Most of the new Medicaid enrollees would have been eligible for the program prior to the passage of the ACA.
Meanwhile, another 8.2 million more people enrolled in employer-provided health coverage, as 7.1 million left the “other” category, and another 1.6 million left individual insurance markets. Only about 3.9 million people actually enrolled in health plans through the state and federal exchanges — not the 7.1 million that Obama has claimed.
Additionally, those who did enroll through the state and federal exchanges did not provide the kind of risk-pool support that is needed to prevent large increases in both premiums and deductibles in the very near future. In fact, according to The Fiscal Times, “Pharmacy benefit manager Express Scripts, which collected more data from insurers than HHS managed through its own exchanges, determined that the incoming enrollees require more medical attention than the previous risk pools, not less — which means that insurers will need to raise premiums even more than first thought.”
Their study shows that enrollees from state and federal exchanges have a 47 percent higher use of specialty medications than those from commercial plans in general.
“Increased volume for higher cost specialty drugs can have a significant impact on the cost burden for both plan sponsors and patients,” the report states. “Despite comprising less than 1 percent of all U.S. prescriptions, specialty medications now account for more than a quarter of the country’s total pharmacy spend.”
Higher premiums and deductibles, coupled with lower-than-advertised enrollment numbers and low turnout for the previously uninsured, has left the president and his backers telling yet another whopper about Obamacare.
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