ObamaCare Week 6: Progress or Political Theater?
The sixth week of the Affordable Care Act’s open enrollment period brought more apologies from the White House, including one from President Barack Obama to Americans who are losing the health-insurance plans he had long promised they would be able to keep.
On Thursday, Obama told NBC News, “I am sorry that they are finding themselves in this situation based on assurances they got from me. We’ve got to work hard to make sure that they know we hear them and we are going to do everything we can to deal with folks who find themselves in a tough position as a consequence of this.”
In the past, the president repeatedly promised that people who liked their current coverage and doctor would be able to keep it under the health-care reform. Thousands of Americans have reported receiving cancellation letters from their insurers ending their policies because they don’t meet ACA requirements.
A bipartisan bill was introduced in the Senate on Thursday by Joe Manchin, (D-W. Va), and Mark Kirk, (R-Ill), to delay the individual mandate for a year. In a statement, the pair said the law is a “common sense proposal [that] simply allows Americans to take more time to browse and explore their options, making 2014 a true transition year.”
The individual mandate requires every American to have enrolled in a health insurance plan by the end of open enrollment period on March 31, 2014, or face a fine of $95 or 1% of the annual income for failing to do so.
Here’s a look at the news and updates surrounding the ACA’s sixth week:
Enrollment
America got some more clarity on numbers this week during Department of Health and Human Services Secretary Kathleen Sebelius’ testimony before the Senate Finance Committee, where she told lawmakers the ACA’s first month will produce “very low” numbers.
“Enrollment seems to be well behind projections,” says Larry Kocot, visiting fellow at the Brookings Institution. “However, there is still plenty of time to recover lost ground.”
A report from the Wall Street Journal early in the week raised some red flags surrounding the age of new enrollees. The newspapers reviewed Kentucky’s state run exchange, which has been faring well performance wise as residents have been able to signup for coverage. As of Nov. 1, 24% of its 4,631 enrollees were under age 34, compared to 39% aged 55 and up.
To control the cost of premiums, insurers need a strong pool of younger (and presumably healthy) enrollees to offset the costs of older customers.
Devon Herrick, senior analyst at the National Center for Policy Analysis, says the reported numbers are not ideal when it comes to enrollee pools, many people will likely wait until the end of open enrollment to sign up, so he isn’t overly concerned about the age trend at this point.
“This is a highly-subsidized bargain for a lot of people,” Herrick says. “But I can see people waiting till the last minute unless their health status is poor.”
Exchanges
The White House set a Nov. 30 deadline to get healthcare.gov running glitch-free, but some experts are doubting all the fixes can be in place on such a short deadline.
Herrick says many features were rushed into the exchange at the last minute, which only led to further delays.
“The administration, for example, rushed in a feature to let people browse without having to buy online so they could call an agent,” he says. “But that interface lets you browse by age- with two choices, over 50 and under 50. They don’t take into account your health status, gender or actual age, so the premium projections you get are incorrect.”
And while anecdotal evidence shows the federal exchange is faring better, Kocot says he is not yet convinced things are in the clear.
“We don’t know how the performance is on the back end and if it is actually improving,” he says. “That is tough to assess.”
Testimony
Both Sebelius and Marilyn Tavenner, administrator for the Centers for Medicare & Medicaid Services, testified this week on Capitol Hill and apologized for the exchanges’ performance over the past six weeks.
Kocot says repeated appearances infront of lawmakers likely did not help public perception of the rollout.
“I don’t know that the testimony has done much to bolster confidence in the overall effort,” he says. “I think members of Congress are still waiting for demonstrated progress before they can be, and will be, convinced these problems have been solved.”
And Herrick says while officials are being held accountable, they may not be the people to give answers on what went wrong.
“They apologize, but they were probably the two people who knew the least about what happened,” he says. “They aren’t the ones in the trenches doing the coding…this is political theater.”