Planning for your financial future? Give your plans a boost with information tailored for you
Start Choosing Here »

Goal Met, Obamacare's Success Not Guaranteed

Health Overhaul What Now
Eric Risberg/APApplicants wait to be called during a health care enrollment event at the Bay Area Rescue Mission in Richmond, Calif., last week.
By RICARDO ALONSO-ZALDIVAR

WASHINGTON -- Seven million people signed up, so there is an appetite for President Barack Obama's health care law, but that doesn't guarantee success for the country's newest social program.

Big challenges are lurking for the next enrollment season, which starts Nov. 15. Chief among them are keeping premiums and other consumer costs in check, and overhauling an enrollment process that was advertised as customer-friendly but turned out to be an ordeal.

"They have demonstrated the law can work, but we are a ways off from being able to judge its success," said Larry Levitt, an expert on health insurance markets at the nonpartisan Kaiser Family Foundation.

Republican opponents of the law keep pushing for a repeal, but as millions of people obtain insurance, how long can the party's strategy remain a politically viable option?

"What the Republicans need to really pay attention to is what they would do different from the Affordable Care Act," said economist Gail Wilensky, who ran Medicare under President George H.W. Bush.

"Just talking about repeal is not going to make it with 7 million people getting insurance on the exchange. And it has to be something reasonably credible ... it can't just be repeal. We are beyond that."

The source of the pent-up demand that propelled health care sign-ups beyond expectations could stem from the nation's new economic reality: a shrinking middle class and many working people treading water in low-paying jobs.

Health insurance has been one of the pillars of middle-class security for decades.
With fewer jobs these days that provide health benefits, there was an opening for a government program to subsidize private insurance.

Enter Obama.

When Medicare and Medicaid were created in the 1960s, policymakers took it for granted that people working steady jobs would have access to health care, said Len Nichols, director of the health policy center at George Mason University in Virginia.

That was "back in the day," Nichols said. "Our assumptions have been all along that you could buy what you needed. But you cannot. And that is why we are where we are."

It could take the rest of the year to sort out how many uninsured people have actually gotten coverage, the ultimate test of Obama's law.

Early statistics provided by the administration have not been useful, mingling uninsured people with those who previously had coverage.

But an ongoing Gallup survey has shown a steady drop in the share of Americans without insurance since Jan. 1, when the law's main coverage expansion took effect. Those numbers should improve because many people still can take advantage of extensions granted by the administration, and because those eligible for the law's Medicaid expansion can apply at any time.

Still, vindication for Obama's law isn't guaranteed. Among the top challenges:

Affordablity

Health insurance premiums tend to go up every year, so the question now is how much higher in 2015.

"How fast they go up will no doubt vary across the country," Levitt said. "Public judgment of the law will be influenced by how rapidly premiums rise."

There's a back-and-forth going on, he said. An improving economy and the law's taxes on insurers will tend to push up premiums. Mechanisms in the law to assist insurers with a disproportionately large share of high-cost patients will push down premiums.

The big unknown is what economic bets insurers made when they jumped into the markets created by the law. If they were conservative and figured a big share of costly cases among the newly insured, that would take some pressure off premiums for next year.

Another important affordability issue has to with deductibles and copayments that consumers have to pay when they use their insurance benefits. Many of the new plans have high out-of-pocket costs, a trade-off for keeping premiums low.

The advocacy group Families USA, which has supported the law from its inception, says the government should nudge insurers to cover more routine medical care outside of the annual plan deductible, the amount consumers pay before insurance kicks in. Right now it's mainly preventive services that are covered outside of the deductible.

Overhauling the Sign-Up Process

One of the law's main goals was to take the mystery out of purchasing insurance, in the same way buying a car is less intimidating these days because prices, quality ratings and loan rates are easily available on the Internet.

But even when the websites are working, the insurance exchanges are anything but easy to navigate.

Finding out what hospitals and doctors are in particular plans requires additional work. Also, experts say it's really difficult to get to a true bottom-line estimate that includes premiums and expected cost-sharing.

"The promise has not been realized," said Robert Krughoff, president of Consumers' Checkbook, a rating service that evaluates health plans for members of Congress and federal employees. "The law says the exchanges will assist consumers in making easy plan choices, and that has not been realized. But it could be."

One common recommendation is to provide consumers with much more in-person assistance to enroll and pick a plan. A change that might help meet that goal is to align sign-up season with tax filing because that could enlist the help of tax preparers.

As it stands now, the administration has scheduled open enrollment season to end on Feb. 15, 2015, right around when most people are just starting to think about filing their taxes.

Krughoff says better online tools are needed to estimate costs and find hospitals and doctors.

"I do think there are many cases where consumers will have joined plans that will cost them a lot more than they could have," he said.


Increase your money and finance knowledge from home

Advice for Recent College Grads

Prepare yourself for the "real world".

View Course »

Economics 101

Intro to economics. But fun.

View Course »

Add a Comment

*0 / 3000 Character Maximum

4 Comments

Filter by:
teapartyisdying.uall

Hey demsbaitnswitch3, I'm leaving lets see if you wait around the next 6 hours when I come back..............LMFAO !!!!!!!!

April 06 2014 at 8:55 PM Report abuse rate up rate down Reply
jojosdixoutcider

Maybe today the Republicans will introduce their healthcare plan.

April 06 2014 at 10:31 AM Report abuse -1 rate up rate down Reply
1 reply to jojosdixoutcider's comment
tru.liberal

Maybe morons will learn that resources are not allocated by a government goon plan.

But I doubt it.

April 06 2014 at 4:53 PM Report abuse rate up rate down Reply
greatbirdusa

As it turns out ---
The Obama administration's Fuzzy math stating their goal of
7.1 million people 'signed up' for ObamaCare is truthfully just over 1 million.!
----- THE OBAMA COVER-UP (S) CONTINUE...!
This Obama Presidency is the least transparent in America's 237-year history.
Which is a politically correct way of saying that
Obama is a deceitful liar who is destroying our country...

April 06 2014 at 7:25 AM Report abuse -1 rate up rate down Reply
hagglkdave

Goal met? Not hardly. If they had done this by Dec 15 2013 then they could claim victory.

April 05 2014 at 2:46 PM Report abuse -3 rate up rate down Reply
kurt koehler

There is no apetite for Obamacare. It is a forced mandate and the IRS will hound you if you don't comply. This is not a free choice to be exercised in the free marketplace.

April 05 2014 at 2:08 PM Report abuse +3 rate up rate down Reply
teapotparty11

MY TEA REP TOLD ME NOT TO SIGN UP AND TO TELL EVERYONE ELSE NOT TO SIGN UP AND TO MAKE SURE YOU MOVE TO A RED STATE THAT WON'T ENFORCE THE PENALTY LIKE MISSISSIPPI, SOUTH CAROLINA OR LOUISIANA PLUS THEY ARE ALL NICE PLACES TO LIVE!!!

April 05 2014 at 1:12 PM Report abuse -5 rate up rate down Reply
jojosdixoutcider

Congrats for meeting the goal, hopefully by the end of the that number will double. Every week for the past few years we have heard the Republicans say they are coming out with their plan next week. Still no plan because one does not exist. The ACA is not perfect but it is a start. Many of these commercials we have seen put up by the so called Americans for prosperity have been proven to be a sham.

April 05 2014 at 12:53 PM Report abuse +5 rate up rate down Reply
1 reply to jojosdixoutcider's comment
tru.liberal

A sham

Like, “If you like your health plan, you will be able to keep your health plan. Period.”

Or more like, If you like your doctor, you can keep your doctor.”

Or maybe more like, “We’re going to work to lower the cost of your premiums by up to $2,500 a year.”

That kind of a sham?

April 05 2014 at 1:02 PM Report abuse -5 rate up rate down Reply
createidea

WASHINGTON -- Seven million people signed up, so there is an appetite for Obama's health care law...

Yeah, right.

LOL !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

April 05 2014 at 11:22 AM Report abuse -1 rate up rate down Reply
1 reply to createidea's comment
tru.liberal

MANY had insurance before losing it to Obamacare.

MOST received subsidies.

ALL avoided paying a fine.

The dumbest 1% imagines this represents an "appetite".

April 05 2014 at 12:43 PM Report abuse -1 rate up rate down Reply
1 reply to tru.liberal's comment
Big John

You are talking about $10,000 deductible useless policies that the insurance companies made a killing on. What subsidies are you talking about? Never had any when I had to pay for individual insurance for ten years that took 30% of my income. Why does it bother people that others have a chance to have health care for a cost when other civilized countries have it for all their citizens. Puzzling how uncaring the people in our country have become.

April 05 2014 at 5:26 PM Report abuse rate up rate down
Lawrence

A little help from the GOP/TEA would be sane approach rather then the barrage of bombs to kill the program. But it's Obamacare not Romneycare or Bushcare so there is little hope for that kind of non-political action.

April 05 2014 at 9:55 AM Report abuse +1 rate up rate down Reply