Is Obamacare working? Jonathan Bernstein, writing for Bloomberg ("How Not to Report on the Obamacare numbers") has learned how not to report on Obamacare's success and he's giving reporters their marching orders:
Hey, reporters! If you’re planning to say anything about the Affordable Care Act's upcoming March 31 numbers, please, please, please read Drew Altman today for an important correction of two mistakes you may be about to make.
So we go to Drew Altman writing for Kaiser Family ("Obamacare: The Metrics In The News Are Mostly Wrong"), the number one journalist who has figured it out for everyone and if we don't follow his method of success, we're wrong. Altman attempts to dispute the importance of the amount of people who sign up. It doesn't matter. That's right, it doesn't matter. The administration has said 7 million would be the important figure by the end of March. When that number looked unattainable it backtracked to say that it wasn't their figure at all and that perhaps 4 or 6 million would do the trick. Okay, whatever. Altman states:
Of course getting to six million has become a political milestone and that won’t change. But the real questions are: Are the premiums (net of the tax credits the government is providing) affordable to people? Will they be stable or begin to spike in year two in some parts of the country if the risk pool is worse than insurers expected? Do people who get coverage under the law think it’s a good deal or not? Does enrollment ramp up as expected over time, decreasing the number of Americans uninsured? The current focus on national enrollment numbers and signups by young adults doesn’t tell us a great deal about the answers to these questions, and they are not a good metric by which to judge year one success.
Altman is being reasonable but he is excusing the obvious in that it does matter how many people are signing up. As of now people are losing their insurance, their doctors, and many are paying higher premiums with enormous deductibles to match. But the jury isn't out, things could get better or worse, fine. To Alman it all depends on the ratio of young healthy adults signing up to subsidize all others "The problem is that it will take time to learn if the mix of enrollees is healthier or sicker, and how premium increases vary around the country, and how people feel about their coverage." That's all.
Why does this have to be so complicated? Obamacare is a law, not a product. No one has a choice as to whether they want to participate or not, they're compelled to. The whole reason for its existence was to ensure 30-40 million who supposedly didn't have insurance and since the deadline for signing up without a penalty is coming soon, why don't we have figures that come close to 20 million? Shouldn't that be the only consideration? If this were a product, it would be out of business. If it were a law with proper consent, then why are there few interested in it to a point of disobeying the law? What's going to change in the months or years to come that will make this thing work if a deadline for a penalty doesn't seem to be very effective?
To Altman the amount of people are not important, per se, the important "metric" is the health of those who do sign up which would make or break the standard insurance model (hence the law itself). Young people are being "knuckleheads", they're not signing up, according to the first lady, because they don't care to be told what to do. Surprise surprise. We should have known that with pot.
The problem with the law is its manner of passage which was designed specifically to skirt consent. As the law was making its rounds in congress, Massachusetts, the bluest of states, elected a Republican to the Senate to stop the thing. This led to congressional machinations where House and Senate reconciliations of their respective versions was bypassed so that the Senate version wouldn't have to meet another Senate vote. The House simply voted in the Senate bill without having time to read what the law was about ("we have to pass it to see what's in it" speaker Nancy Pelosi famously said) thus nullifying the decision of the people of a blue state that didn't like the law and forcing the population to comply with a Pandora of regulations and mandates yet to be seen.
The following year Democrats lost their majority in the House of Representatives and as news of "what's in the law" gets worse they are now about to lose the Senate this year as well. The governed are having their say and to stem the tsunami of dissatisfaction with Obamacare, Obama has arbitrarily changed the law without congress to delay its full implementation till after the mid-term elections. Nothing is normal here.
There is nothing about the law that makes it appealing. The only people who like it are congressional Democrats who are not up for reelection who so happen to be exempt from participation, also diehard liberals who only care about partisan score keeping. As for a majority of Americans, which is the sole indication of success of failure not some ratio of sick to healthy participants, this thing is a dud. That's how you gauge its success.