The Great Obamacare Rollout
- This may be the last gasp of the Obama election turnout machine before he fades as a force in elections. The publicly-funded hundred million dollar advertising campaign and army of “navigators”; the celebrity endorsers; the mainstream media publicizers; the daily social media exhortations of Organizing for America working with the carrot of more free stuff and the stick of the individual mandate got 7 million folks to fight their way through the complexity and the HHS’ technical ineptitude. The President’s palpable relief is understandable.
- There is good reason that Sibelius cannot answer the obvious and easily-answerable questions about the numbers – how many of the sign-ups were previously insured; how many had had their insurance cancelled; how many have actually paid their premiums; what are the demographics of the enrollees? When this journey began in 2009, the claim was that we had to take care of the 50 million uninsured. The administration likes to tout the 7.1 million signed up on the exchanges, the 4 million signed up for expanded Medicaid (about half being normal annual adds), and the 3 million kids being added added under the “slacker-care” provisions. Net, net, Forbes’ analysis suggests the total number of beneficiaries at about 7 million.
- The insurance company actuaries are working overtime. The lack of disclosure of the age/gender/medical condition mix of enrollees suggests that the premiums and deductables for middle class folks who do not qualify for subsidies will most likely need to be bumped significantly (again) in the rates for 2015 to be announced shortly before the November elections. This is, after all, a transfer from the upper and middle income classes to the subsidy-entitled lower class with the money coming partly from direct tax-payer subsidies and the rest from mandate-driven insurance rates.
- The public is not much concerned about fraud. According to Rasmussen just 19% of likely voters think that the IRS should use their resources to police the “honor system” income claims of those seeking subsidies. Obama’s permission slip to ignore the deadline for sign ups drew hardly a yawn. Such is the state of American ethics.
- The 2014 Congressional elections will see “Big Data” Get Out the Vote efforts, with Democrats using the contact information of the 7 million enrollees (and the 4 million added to Medicare), and the Republicans using that of the millions who had their policies cancelled. Fortunately for Republicans, many of the sign-ups were in liberal states like New York and California, lost causes anyway.
- With the last six months’ focus on insurance enrollment, there has been little discussion of expanded capacity. The latest “doc fix” to avoid a mandated 24% reduction in Medicare reimbursement rates sailed through Congress, preventing an exodus of doctors, and medical school enrollment is up slightly.
- The drag on the economy with a disincentive for small businesses to hire and the coming enforcement of the large employer mandate in 2015 continues unabated with the Congressional Budget Office projecting a net loss of the equivalent of some 2,000,000 workers from Obamacare’s taxes and hiring disincentives.
Good for Republicans, Nancy Pelosi still thinks that Obamacare is a winning issue for Democrats in marginal districts despite being under water in the polls by about 40% to 60%. Hopefully at least a few Democrats running in Red states will believe her.
This week’s “bonus” is an excellent article by Dan McLaughlin of RedState about the eight points that Republicans agree on for an Obamacare replacement, and Bobby Jindal’s plan. (This may help move the Louisiana governor into the top tier of 2016 candidates.) We normally end with a video, but this is too good to pass up.