Obamacare success not all about numbers
February 20th, 2014
04:02 PM ET
8 months ago

Obamacare success not all about numbers

(CNN) - Vice President Joe Biden said what others have basically conceded - the Obama administration may fall short of its original enrollment target for Obamacare.

That might give critics another reason to attack the health care law, but the acknowledgment is consistent with what number crunchers have said previously.

"Initially, we talked about by the end of this period having 7 million people lined up. We may not get to seven, we may get to five or six, and that's a hell of a start," Biden told a gathering during an unscheduled stop in Minneapolis.

The nonpartisan Congressional Budget Office predicted similar numbers in its latest budget outlook released earlier this month.

Due in part to numerous technical problems with the government's online insurance exchange, HealthCare.gov, CBO lowered its prediction for how many people would be enrolled in the first year from 7 million to 6 million.

But health policy expert Larry Levitt said the lower figure is unlikely to have a huge impact on the health of the law as a whole.

"The overall enrollment number is essentially an arbitrary figure that comes from CBO's original projections of what they thought the bill would do," said Levitt, a senior vice president at the independent Kaiser Family Foundation. "This 7 million projection from CBO has taken on a life of its own."

Total enrollment is certainly important if the law is to succeed in its central goal of growing the population of people with health insurance in America.

However, what's more crucial to the viability of the Affordable Care Act, Levitt explained, is the health of the people signing up, not how many of them there are.

"What's much more important in the first years is they get the right mix of enrollees so the insurance market is stable," Levitt said. "Regardless of how many people are enrolling, what matters a lot more is that they're getting healthy people as well as sick people."

The first clue as to how successful the administration's been in recruiting a diverse group of enrollees will come sometime over the summer, when insurance companies begin submitting their rates for 2015.

"When insurers set their premiums for 2014, many of them built in some padding, assuming they were going to get an older sicker pool of enrollees," Levitt said. "When they set their premiums for 2015, they'll be looking at who actually signed up compared to what they expected."

If premiums for 2015 go up, it will signal that insurance companies feel the customers who've enrolled are sicker – and thus more expensive – than expected. But if premiums stay steady or even go down, it will show that the pool of customers who signed up in 2013 and 2014 met their expectations.

The effect that lower total enrollment has on the broader goal of expanding health coverage may be a bit trickier to calculate.

Under the new law, access to insurance is not limited to the exchange. Millions of people have already been enrolled through state Medicaid offices, and countless others have purchased insurance off of the exchange, whether directly from an insurance company or through a broker or private insurance marketplace.

Later this year, population surveys will begin to provide information on how many people are still uninsured, but that data may not reflect the impact of the entire six-month open-enrollment period.

In the spring, insurance companies will begin filing quarterly reports to state regulators detailing how many people they insure, and organizations like Kaiser will aggregate that data to paint a nationwide picture.

But Levitt points out even this data may be problematic.

"We'll probably have a data brawl over these numbers for the rest of the year," Levitt said. "We'll be able to see how many more people are insured, how many fewer people are uninsured. What's not knowable is what would've happened in the absence of the Affordable Care Act."


Filed under: Joe Biden • Minnesota • Obamacare
soundoff (19 Responses)
  1. Bill from GA

    Whatever the numbers on Obamacare, they are sure to be better than W's on WMDs: Big Fat Zero.

    Thousands of lives lost on W's legacy venture. Thousands with healthcare on Barry's legacy venture.

    February 20, 2014 04:18 pm at 4:18 pm |
  2. huh???

    How is it a hell of a start Mr. Biden when your own statisticians have shown those who signed up for obamacare we're those who already had insurance and that those uninsured millions are still overwhelmingly uninsured? Furthermore, your new law led to the cancellation of 5million insured Americans. Lets see, if we give you the benefit of the doubt, come the deadline you'll have insured (arguably at best) 6million – 5million = 1million people. 1 milloon people in half a year is a good start? Your law will implode on itself at this rate, especially if obama keeps giving big businesses extentions on upholding their end of the bargain. Go figure though, graduate from HarvHarvard and suddenly ligics and reason can be throw out the windoe.

    February 20, 2014 04:21 pm at 4:21 pm |
  3. Rick McDaniel

    What success? This plan is a failure by any number of measures........and none of those measures would indicate any success whatsoever.

    February 20, 2014 04:24 pm at 4:24 pm |
  4. king

    my aunt and niece just signed up for obamacare. hey they are happy as hell. the repubs will regret their adamant war on helping millions of people from bankruptcy when they get sick. they will be in trouble when millions more get a better deal with obamacare than their junk policies they had to give up. time is the repubs worst nightmare right now. they tried like hell, to convince folks to throw away their best interest. but their were a few democrats that sacrificed their political careers to make sure that people get affordable healthcare coverage. and let us thank those dems who sacrificed their careers just to save us all. repubs you will get yours in the end.

    February 20, 2014 04:38 pm at 4:38 pm |
  5. The REAL Truth...

    @Rick McDaniel – This plan is a failure by any number of measures........and none of those measures would indicate any success whatsoever.
    -----------------------
    But if a GOP administration had actually implemented the ACA (it IS a conservative plan.. at least 95%) instead of Obama's admin, you'd be singing it's praises up and down every street.. Hilarious!

    February 20, 2014 04:38 pm at 4:38 pm |
  6. If you believe THAT...........

    They bragged about the numbers....................they failed to get the numbers.....................so now it's not about numbers at all!
    Boy! When you're a Democrat you really have to think on your feet! And they called Mr Romney a flip-flopper! lol

    February 20, 2014 04:41 pm at 4:41 pm |
  7. Brian

    Obamacare = FAILURE
    Billions flushed on another government Ponzi scheme...

    February 20, 2014 04:49 pm at 4:49 pm |
  8. Name Uche Agonsi

    When I was a kid, that was about 82 years ago and 3months, the sight of pudding horrified me as I couldnt brave myself to eat the food, until my loving mother taught me to eat it with cane. I never left eating pudding even today. So also is noodles i thought were coiled worms. They both make up my prefered menu today. May be these Repubs & their anti-Obamacare allies should be courageous enough to stop talking nonsense to the ACA but just consume it. You may never know it might turnout to be their best healthcare menu.

    February 20, 2014 04:57 pm at 4:57 pm |
  9. Name jk. Sfl. GOP CRUZ lee&rubio 24billion dallar LOSS of your tax money conservatives,the garbage of America.

    It's working and the GOP is going to lose the house and senate over it . Hiding BEHIND obamacare doesn't make up for your six years of GOP incompetence and o accomplishments. Pack your bags GOP clowns , your in for a rude awakening in NOVEMBER!!!!!!!

    February 20, 2014 05:07 pm at 5:07 pm |
  10. Sniffit

    "Waaaaah, they're going to meet their targets late" = "Waaaah, the website was broken for 2 months." No difference. There really is NO other reason the targets won't be met on time. None. They'll meet them in May or June or so and what...2 months delay is the sky falling in the grand scheme of things? Nope.

    What CNN really means when it says things like "That might give critics another reason to attack the health care law" is "please do so, because we've got 24 long hours of news cycle to try to fill up and we need material."

    February 20, 2014 05:15 pm at 5:15 pm |
  11. Gurgyl

    GOP needs to recite this three times a day–"Obama is bad, Obamacare, Benghazi". Standing on one leg facing east. God appears to appease these idiots that are crying on Nation's most needed ACA Law.
    PS: no more crying on Obamacare, it is a need, and success.,

    February 20, 2014 05:20 pm at 5:20 pm |
  12. Silence DoGood

    The numbers have been delayed by the out-and-out sabotage by the Radical Right (the "moral" ones) as reported Oct-Nov 2013. Stopping young people (Koch beer campaign), conservative website ddos h@ackers, fake websites. If ACA was so doomed to self-failure, why did they need to attempt sabotage?

    February 20, 2014 05:25 pm at 5:25 pm |
  13. Sniffit

    "If premiums for 2015 go up, it will signal that insurance companies feel the customers who've enrolled are sicker – and thus more expensive – than expected. But if premiums stay steady or even go down, it will show that the pool of customers who signed up in 2013 and 2014 met their expectations.

    And the part CNN doesn't want to talk about: if insurers end up sending out $1B+ in rebates again because of the 80/20 rule (requiring them to spend 80% of premiums collected on actual medical care or refund the difference), it will prove that the insurers/underwriters are acting unnecessarily scared by jacking up their premiums and that the fearmongers who tried to use those inflated premiums to score political points will be proven wrong AGAIN.

    February 20, 2014 05:26 pm at 5:26 pm |
  14. Sniffit

    "Later this year, population surveys will begin to provide information on how many people are still uninsured"

    Get ready for the GOP/Teatrolls demagoguing this the way they demagogue the census. In the case of the latter, they knew what the census would say about the growth in minority populations and how that would need to play into redistricting. In the case of the former, they're not going to like the good news about the growth in the number of insured.

    February 20, 2014 05:28 pm at 5:28 pm |
  15. Getoverit

    @The REAL Truth
    But if a GOP administration had actually implemented the ACA (it IS a conservative plan.. at least 95%) instead of Obama’s admin, you’d be singing it’s praises up and down every street..
    -------
    You mean just like you are now?

    February 20, 2014 05:31 pm at 5:31 pm |
  16. Sniffit

    "What's not knowable is what would've happened in the absence of the Affordable Care Act.""

    Right. Because for some unknown cosmic reason, umpteen million uninsured people were going to end up insured or added to the Medicaid program if we just did nothing....like we've done for decades while the number of uninsured people grew and grew and grew and grew. It was just totally unknowable whether reality would suddenly function in a different manner this year than it has for the past several decades. I suppose that explains the GOP/Teatroll's insanity...when you reject a clear historical record full of poignant data, of course you think you can do the same thing over and over again and the result might be different next time.

    February 20, 2014 05:31 pm at 5:31 pm |
  17. CALIFORNIA

    Obamacare is STILL a massive boondoggle.

    February 20, 2014 05:34 pm at 5:34 pm |
  18. Silence DoGood

    Thanks Mr. President for freeing me from the fear of sickness cancellation, life time maximum, and being turned down for insurance. The Radical Right and corporate friends have lost yet another fear with which to manage the population.

    February 20, 2014 05:35 pm at 5:35 pm |
  19. Abbey

    Here we go folks, another attempt to change the narrative on Obamacare. These progressive hillbillies are really starting to snivel over this debacle since it clearly shows what happens when the liberal agenda gets it's hooks into the taxpayers pocketbook.

    February 20, 2014 05:40 pm at 5:40 pm |