One "tech surge" and five months later, enrollment in these exchanges under Obamacare is on track to surpass original goals, greatly beating revised expectations that were tempered after the first month. According to The Associated Press, enrollment was expected to pass 7 million.
The Congressional Budget Office initially projected last May that enrollment in the taxpayer-subsidized private exchanges would be 7 million. They revised that number in February, amid still-lagging numbers from the law's rollout.
Even at the end of February, it seemed unlikely the Obama administration would even hit the revised target of 6 million. By then, only 4.2 million people had signed up for insurance through the exchanges, and momentum appeared to be sagging.
One Democratic strategist compared the last month's rush to doing taxes right before the deadline. Monday — deadline day — was a record-breaking day for HealthCare.gov, which saw more than 3 million visits as of 8 p.m. More than 1 million calls were placed into the health insurance marketplace's call center as of 8 p.m., also a record.
There are a few big caveats with any topline numbers — the Obama administration hasn't said how many people who signed up on the exchanges have actually paid their first month's premiums.
We also don't know how many people who signed up through the exchanges were previously uninsured — though The Los Angeles Times reported that through the marketplaces, other forms of private insurance, and through the law's expansion of Medicaid, more than 9.5 million previously uninsured people have gained coverage.
Lastly, the final demographics of those who signed up will be important. Young and healthy people signing up are crucial to the success of the law, as their inclusion will help subsidize older and sicker enrollees. As of January, only 25 percent of the total signups were between the ages of 18 and 34. The Obama administration had hoped that number would be around 40 percent.
It's also unclear how much the good news of the enrollment numbers will affect the politics of the law, which are expected to be the lightning rod of the 2014 midterm elections. A Fox News poll released last month found Obamacare's popularity tied for its all-time high at 40 percent. Still, people said they opposed the law by a 56-40 margin.
But on Tuesday, the Obama administration took its opportunity to gloat:
Millions of Americans with the economic security that comes from having health insurance is EXACTLY what Change looks like
In a statement from the White House Rose Garden on Tuesday afternoon, President Barack Obama took a victory lap on the end of the first open enrollment period under the Affordable Care Act.
It came on the same day that the White House announced that more than 7 million people had enrolled in insurance plans through Obamacare, surpassing the administration's original goal despite a disastrous rollout of the law in October.
Noting the "lost weeks" that came with the rollout of the law, Obama announced that more than 7.1 million people had signed up.
"This law has made our health-care system a lot better," Obama said.
"In these first six months, we've taken a big step forward," he said. "Under this law, the share of Americans with insurance is up and the growth of health-care costs is down."
Obama didn't hold back against those he perceived as reactionary critics of the law. He ratcheted up his rhetoric against Republicans he said were trying to dismantle the law, quipping that there are "still no death panels."
"Armageddon has not arrived!" he said.
He had a message for the press, saying he could "guarantee" there would still be some unforeseen problems and glitches to come.
"There will be days when the website stumbles," Obama said. "It's going happen, and it won't be news."
Michael Steel, a spokesman for House Speaker John Boehner, noted the president's "victory lap" but said despite the enrollment figures, the law "continues to harm the American people."
"Every promise the President made has been broken — health-care costs are rising, not falling," Steel said. "Americans are losing the doctors and plans that they like, especially seniors suffering under President Obama’s Medicare cuts. Small businesses are afraid to hire new workers, hobbling our economic growth.
"That’s why we must replace this fundamentally flawed law with patient-centered solutions that will actually lower health-care costs and help create jobs," Steel said.
The Congressional Budget Office initially projected last May that enrollment in the taxpayer-subsidized private exchanges would be 7 million. They revised that number in February amid still-lagging numbers from the law's rollout.
Even at the end of February, it seemed unlikely the Obama administration would even hit the revised target of 6 million. By then, only 4.2 million people had signed up for insurance through the exchanges, and momentum appeared to be weakening.
One Democratic strategist compared last month's rush to doing taxes right before the deadline. Monday — deadline day — was a record-breaking day for HealthCare.gov, which saw more than 3 million visits as of 8 p.m.
More than 1 million calls were placed into the call center of the health-insurance marketplace as of 8 p.m., also a record.
There are a few big caveats with any topline numbers — the Obama administration hasn't said how many people who signed up on the exchanges have paid their first month's premiums.
It's also not known how many people who signed up through the exchanges were previously uninsured, although The Los Angeles Times reported that through the marketplaces, other forms of private insurance, and through the law's expansion of Medicaid more than 9.5 million previously uninsured people have gained coverage.
The final demographics of those who signed up will be important. Getting young people and healthy people to sign up is crucial to the success of the law, as their inclusion will help subsidize older and sicker enrollees.
WASHINGTON (AP) — Here's more fallout from the health care law: Until now, customers could walk into an insurance office or go online to buy standard health care coverage any time of year. Not anymore.
Many people who didn't sign up during the government's open enrollment period that ended Monday will soon find it difficult or impossible to get insured this year, even if they go directly to a private company and money is no object. For some it's already too late.
With limited exceptions, insurers are refusing to sell to individuals after the enrollment period for HealthCare.gov and the state marketplaces. They will lock out the young and healthy as well as the sick or injured. Those who want to switch plans also are affected. The next wide-open chance to enroll comes in November for coverage in 2015.
It's a little-noted consequence of President Barack Obama's health care overhaul, which requires nearly all Americans to be insured or pay a fine and requires insurers to accept people with health problems.
"I have people that can buy insurance, but the companies shut them down. They won't take the applications," insurance broker Steve Bobiak of Frackville, Pa., said. "We're a free country. You should be able to buy anything anytime you want."
Those who act now may still be able to get in, depending on where they live. Following the lead of the government marketplaces, some companies are extending off-marketplace sales for a week or a month to help people who hit snags trying to enroll by this week's deadline. Rules vary from state to state.
After those extensions, eligibility for coverage during 2014 is guaranteed only for people who experience certain qualifying life events, such as losing a job that provided insurance, moving to a new state, getting married, having a baby or losing coverage under a parent's health plan.The federal law doesn't prevent companies from selling policies to everyone all year. But insurers consider it too risky now that the law prohibits them from rejecting people in poor health.
"If you didn't have an open enrollment period, you would have people who would potentially enroll when they get sick and dis-enroll when they get better," said Chris Stenrud, spokesman for insurer Kaiser Permanente. "The only insured people would be sick people, which would make insurance unaffordable for everyone."
Bobiak, whose NICA Benefits company helps people buy insurance in New Jersey, Ohio and Pennsylvania, said he learned only a couple of weeks ago that insurers were cutting off new policies.
"It's lousy communication out there," he said. "If we don't know, my God, how do they expect other people to know? It's terrible."
A survey by the Kaiser Family Foundation in mid-March found that 6 out of 10 people without insurance weren't aware of the marketplace deadline on March 31. The Obama administration, insurance companies and nonprofit groups scrambled to spread the word, often with messages that focused on the cost savings available to many people through the government marketplaces.
There wasn't much public discussion about people who prefer to buy policies outside the marketplaces, sometimes finding better deals or options more to their liking.
Health and Human Services spokesman Aaron Albright pointed to a cryptic note on the HealthCare.gov website: It says "in some limited cases some insurance companies may sell private health plans outside the marketplace and outside open enrollment" that satisfy the law's coverage mandate. It doesn't say how to find any companies doing that. Albright had no further comment.
Gary Claxton, a health law expert at the Kaiser Family Foundation, said it's "highly unlikely" that companies will offer such coverage after the deadline window fully closes. Some do still offer temporary plans, lasting from a month to a year. But those plans don't cover pre-existing conditions and don't get buyers off the hook for the law's tax penalty.
Nate Purpura, spokesman for eHealthInsurance.com, which sells policies from 200 companies across the nation, said at this point he knows of none planning to offer major medical insurance after this month, except to people with qualifying life events.
For people trying to get an off-marketplace plan through an open enrollment extension, some insurers are selling them through April 15, and others through the end of the month. Purpura said eHealth will offer such plans in at least some areas of these states: Arizona, California, Georgia, Hawaii, Louisiana, Maryland, Michigan, Nevada, New Mexico, Ohio, Oregon, Utah, Virginia and Washington state.
Kaiser Permanente will offer extensions that mirror the state or federal marketplace in the area where a plan is sold, Stenrud said. The federal marketplace extension for online enrollment is April 15. But Oregon, for example, is giving marketplace buyers until April 30.
After that, Stenrud said, without a qualifying life event, the door closes until Nov. 15.
The intense conservative ire for Obamacare may seem like an anomaly in American history. But it's eerily reminiscent of two other large -- and now widely popular -- expansions of the safety net: Social Security and Medicare.
The two programs are now a staple of American political culture. But a backward glance at the political environment during their inception reveals equally fierce, ugly antipathy from conservatives -- including screaming warnings that they'd be ruinous to freedom.
During the 1935 debate over Social Security, Republicans likened it to slavery and dictatorship.
"Never in the history of the world has any measure been brought here so insidiously designed as to prevent business recovery, to enslave workers and to prevent any possibility of the employers providing work for the people," said Rep. John Taber (R-NY).
"The lash of the dictator will be felt," said Rep. Daniel Reed (R-NY), "and 25 million free American citizens will for the first time submit themselves to a fingerprint test."
Rep. James W. Wadsworth (R-NY) cautioned that passage of Social Security would open the door to a government power "so vast, so powerful as to threaten the integrity of our institutions and to pull the pillars of the temple down upon the heads of our descendants."
Three decades later, when Medicare was first conceived in the early 1960s, the public was deeply divided, and similar warnings were voiced. Embodying the conservative movement's sentiments at the time was Ronald Reagan, who taped a recording on behalf of the American Medical Association warning that the program would, quite simply, lead to the destruction of freedom.
"If Medicare passes into law, the consequences will be dire beyond imagining," Reagan said. If opponents failed to scuttle it, he warned, "One of these days you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free."
Republican presidential nominee Barry Goldwater, in 1964, likened Medicare to free vacations and beer. "Having given our pensioners their medical care in kind," he said, "why not food baskets, why not public housing accommodations, why not vacation resorts, why not a ration of cigarettes for those who smoke and of beer for those who drink?"
Half a century later, Republicans loudly and proudly proclaim their support for both programs, and are loathe to admit their party ever opposed them.
But history repeats itself. In 2010, Democrats passed the Affordable Care Act -- the largest expansion of the safety net since Medicare -- following a similarly intense debate. Democrats heralded it as a step toward a more humane society, and Republican opponents warned it would pose a grave threat to economic freedom. Unlikely Social Security and Medicare, Obamacare failed to win over even a fraction of Republicans, who were reduced a small, deeply ideological rump in both chambers of Congress after two landslide elections for Democrats.
This week, Obamacare took a leap toward sustainability as it crossed the milestone of 7 million insurance sign-ups. Even as conservative wonks concede that the program is probably here to stay, the residue from the hyper-partisan and polarizing debate lingers, and Republicans remaincommitted to dismantling it. But if past is prologue, over time as the coverage expansion and benefits fully take effect, the fatalistic warnings will fizzle and Republicans will come to terms with the new health care program.
"In politics, losses always worry people more than abstract future gains entice them. Now, every vote to repeal or eviscerate Obamacare risks offending millions – and the potential to arouse pushback will only grow," argued Theda Skocpol, a Harvard professor, sociologist and liberal author. "This story isn’t like Social Security, where most potential beneficiaries saw few gains for two decades. Affordable Care is already a massive presence in U.S. health care. It cannot be rolled back and those who keep championing that Lost Cause will do so at rising political peril."
This weekend's "Saturday Night Live" mocked how "Fox and Friends" covered this week's Obamacare and climate change news.
Meet the show's "hosts" Steve Doocy, Elisabeth Hasselbeck, and Brian Kilmeade.
"President Obama did his best to make us all sign up for Obamacare," Doocy started off the show by saying.
"And wow, it wasn't easy," noted Hasselbeck.
To which Kilmeade responded, "It's tough to sign up for things, I've tried for years to sign up for the NAACP."
Getting things back on track, Doocy explained, "Now that the deadline has passed, the White House is claiming that they've met their goal. But look at our Fox News chart. As you can see, Obama needed to get 7 million new subscribers and he only got 7.1 million. Not anywhere close."
"I made a pie chart," added Kilmeade. "This area represents the part where I was hungry."
After talking to a "victim of Obamacare" played by "SNL" host Anna Kendrick, the show switched gears to address the study that came out this week about climate change.
"It's so confusing, so we thought we would bring in a scientist to help us out," said Doocy. "From Fox's 'Cosmos,' please welcome Neil deGrasse Tyson."
"This report actually represents the consensus of the vast majority of scientists," explained deGrasse Tyson, expertly played by Kenan Thompson. "It is an indisputable fact that the earth is getting warmer."
To which Kilmeade added, "I saw a documentary about a town that was always cold because of a princess."
"That was 'Frozen,'" Hasselbeck corrects.
"Whoa, whoa, whoa, Dr. Tyson, the polar bears are just fine," exclaims Doocy. "In fact, just the other day I saw one wearing sunglasses and drinking Coca-Cola."
"I think you're referring to a commercial," deGrasse Tyson points out, continuing, "I would advise each of you to study the science, for science is truth indeterminate and science allows us to detect when people's philosophies are interfering with the dissemination of those essential truths."
These were the hosts' stunned responses:
Before the show was over, they issued a list of corrections from the first hour.
And according to the study, the uninsured rate dropped due to a development no one saw coming that had nothing to do with the controversial health care exchanges established by the law.
According to the RAND Corp. survey, which was released on Tuesday, a net 9.3 million people have gained coverage since September — something that helped plunge the uninsured rate in the U.S. from 20.5 percent to 15.8 percent.
The RAND study comes with a big caveat, however. The topline number of 9.3 million contains a margin of error of 3.5 million people. That means as few as 5.8 million people could have gained coverage, or as many as 12.8 million.
Either way, it's still a big deal, said Christine Eibner, a senior economist at RAND and one of the study's two authors.
"All surveys are going to have this margin of error," Eibner told Business Insider in a phone interview Tuesday. "That's to be expected, because we're extrapolating results from a very small sample of the full population of the U.S., but nevertheless, the margin of error is telling us that we can have a high degree of confidence in the direction of our results, in that we've seen an increase in insurance. Because 9.3 minus 3.5 is still a significant increase."
In spite of these eye-popping topline numbers, the most interesting finding from the study might be the reason for the decrease in the uninsured rate. RAND projects it was due to growing enrollment in employer-sponsored insurance — programs that exist outside of the exchanges created by the Affordable Care Act. Enrollment in these ESIs grew by more than 8 million from September through mid-March. This includes a large swath of individuals — 7.2 million — who were previously uninsured.
These numbers seem surprising on their face, but, Eibner said, they make sense.
"One thing that got lost in the discussion — the Affordable Care Act really wasn't just about covering people on the marketplaces," she said. "The law was intended to expand insurance coverage using a whole bunch of different programs, including the existing system, which is heavily based on employer-based coverage."
Eibner also added "any change" in the regulations governing ESI would be the primary factor behind movement in the overall insurance rate since, even with the new "Obamacare" exchanges, ESI remains "the major source of coverage" for most people in the country.
The apparent increase in number of people insured with ESI identified in this study could be statistical noise that doesn't completely reflect reality. Indeed, few experts predicted the Affordable Care Act would lead to a surge in employer-based coverage. In May 2013, for example, the Congressional Budget Office projected the ranks of the insured through employers would rise only 1 million. Furthermore, RAND doesn't have any data on possible reasons for the huge surge in employer-sponsored insurance.
However, Eibner offered several ways the Affordable Care Act could actually have led to a surge in the number of people insured with ESI:
Obamacare's individual mandate and its potential penalty could be providing an incentive for individuals who had foregone coverage to sign up under their employers.
Some firms could be new offering coverage due to the ACA. However, Eibner also noted the law has created very mixed incentives for employers to do that thus far.
The slow-but-steady economic recovery could also be a contributing factor. The unemployment rate dropped a half a percentage point from September to March. With more jobs comes the potential for more people covered.
Additionally, another survey released by Gallup Monday came up with a similar number to RAND's 15.8 percent uninsured rate. In fact, Gallup put the uninsured rate even lower at 15.6 percent, its lowest level since 2008. However, while the Gallup survey would seem to support the RAND study's conclusion the overall uninsured rate had dropped, it did not distinguish between types of coverage and doesn't make clear whether the decrease is due to more people being insured with ESI.
The RAND study was completed through rather unusual methods. The results in the survey are based on a representative sample of 2,425 adults between the ages of 18 and 64 who responded to the survey in both March 2014 and September 2013.
The Obama administration said last week enrollment through the healthcare exchanges had surpassed an original goal of 7 million. RAND's study only takes into account data from September through mid-March, which means subsequent studies should reflect the late surge in exchange enrollment in addition to any growth in the number of people insured with ESI.
Florida Gov. Rick Scott (R) has been called out for two misleading campaign ads that suggest as many as 300,000 Floridians have lost their health insurance coverage through Obamacare, according to The Miami Herald.
On Wednesday Scott deflected questions by reporters about the ads, produced by the Pro-Scott political committee Let’s Get to Work.
"Clearly, the ad's accurate [sic]," Scott said. He refused to elaborate.
The insurance company that the claim is built around is Florida Blue, which warned last fall that 300,000 of their customers' insurance plans could be cancelled through Obamacare because those plans didn't comply with the law.
But Florida Blue told the Herald that, contrary to the ads, 300,000 plans had not been canceled through Obamacare.
"To date, most of the members in our pre-ACA plans have kept their plans," Florida Blue spokesman Paul Kluding said.
Kluding did say in his statement that some Florida Blue customers decided to drop their old plans because of the better deals offered in new plans they could get under Obamacare.
"We had a special outreach to those members who were advantaged to move to ACA plans, either because of potential subsidies, or because they would benefit from the new coverages and/or better premiums," Kluding said. "Based on that outreach, about 20 percent of the targeted members moved from previous Florida Blue plans to ACA plans."
Politifact, the Miami Herald noted, fact checked the ads and said the accusation that 300,000 health plans had been canceled was "mostly false." As Politifact noted, in 2013 Florida Blue sent letters to 300,000 customers explaining that some Florida Blue plans did not comply with the Affordable Care Act but did not mean those members would be left without insurance.
Unsurprisingly, the ads do not note that according to the Obama administration 442,000 Floridians opted for a plan through Obamacare as of March 1, the Herald noted.
Scott had not been directly questioned by reporters about the ads until Wednesday when he was pressed at the Armando Badia Senior Center in Florida during a meeting with senior citizens. Scott did add some nuance in his statements on Wednesday about the cancellations claim.
"We were already told last fall that 300,000 Floridians were going to lose their insurance," Scott said.
When pressed about the ads' 300,000 plans claim, Scott just pivoted back to railing against Obamacare.
"If you look around the state, Obamacare has had an impact on a lot of people's plans," Scott said. "They're losing their doctors. And they're losing the plans."
Watch video of Scott addressing the claim, via American Bridge:
Below are two ads from the Rick Scott's Let's Get To Work re-election campaign effort that include the 300,000 plans lost claim:
U.S. President Barack Obama and departing Secretary of Health and Human Services Kathleen Sebelius took another victory lap on Friday, declaring the Affordable Care Act a success in a press conference during which Obama announced Sebelius' resignation.
In announcing Sebelius' departure, Obama heaped praise on Sebelius, saying she would "go down in history" for being the HHS Secretary when "health care became a right," not a privilege.
Obama announced that he was nominating White House Office of Management and Budget Director Sylvia Mathews Burwell to replace Sebelius as HHS Secretary. He said he hoped the Senate confirmed Burwell "without delay."
Sebelius' statement on her resignation was perhaps befitting of her tenure at HHS, and of the law's overall rollout. She was missing a page of the prepared remarks of her speech.
At the same time, the law's costs to the federal government are shrinking. According to the new projections, the federal government will spend more than $100 billion less on Obamacare's coverage provisions through 2024 than previously projected. That includes a downward estimate of about $5 billion this year. Overall, spending on the federal and state insurance exchanges are projected to cost 14% less than originally forecast.
The CBO said plans offered through the exchanges are narrower, allowing companies to keep premiums low and the federal government to pay less in subsidies. The lower spending projections on the Affordable Care Act will help shrink deficits overall. The CBO said the federal government will now run a deficit of $492 billion in fiscal year 2014, which is almost a 33% decrease from 2013.
Through both the federal and state insurance exchanges and the expansion of the federal Medicaid program under the law, the CBO projects more than 12 million people now have insurance who wouldn't have normally been covered in the absence of the law. The CBO also projects 19 million people will gain coverage by 2015, 25 million more by 2016, and 26 million more by 2026.
In 2014, according to the CBO, about 6 million people gained insurance from the exchanges and close to 7 million people benefitted from the Medicaid expansion. Those gains reduced the number of uninsured in the U.S. to 42 million —16% of the population. By 2024, the CBO projects, about 89% of U.S. residents will have health insurance.
Here's a chart from the CBO showing the parallel universe between a U.S. with the Affordable Care Act in 2024 and one without it:
There's one key difference between the CBO's projections and a study released last week by RAND Corp., which said a net 9.3 million people had gained insurance coverage from September through March: The RAND study said most of those who gained coverage did so through employer-sponsored coverage, something the CBO said did not contribute to any relative gains in coverage.
The Obama administration has spent much of the past two weeks trumpeting the law in spite of a disastrous rollout. Former Secretary of Health and Human Services Kathleen Sebelius, who resigned last week, said 7.5 million people had enrolled in plans through the exchanges by the end of the law's first open enrollment period on March 31.
Last weekend's Freedom Summit rally in New Hampshire provided a preview of how top Republicans hope Burwell's confirmation process will let them renew focus on "Obamacare," with polls indicating hammering the law could cement several GOP victories in the upcoming midterms.
"She'll essentially be in charge of what's left of trying to make a system that hasn't been working very well work," Paul told reporters at an event in Dover on Friday. "So I think it's legitimate to ask her some questions on how she's going to make it better."
Burwell is almost certain to be confirmed — eventually. Senate rules changes last year ensured any presidential nominees only need a majority of Senators' votes to be confirmed. With the Democratic Senate majority, that means no Republicans will have to vote for Burwell. Instead, Republicans plan to use Burwell's confirmation hearings to take on Obamacare, which they're hoping will lead to a political windfall in the upcoming mid-term elections.
On Friday, Paul rattled off some of those potential questions that could pop up during Burwell's confirmation proceedings. What happens if rates go up significantly? How many people have fully enrolled in plans through the exchanges, including paying their premiums? Will employers scrap renewing their plans in the small-group market and push employees onto the exchanges? And will there be any unexpected surprises, such as patients learning they may have fewer options under their new plans?
Burwell's confirmation hearings will also be a time for Republicans to question her about some of the more controversial aspects of the law. For example, they will likely ask Burwell to explain why President Barack Obama kept making the now infamous promise people would be able to keep their insurance plans if they liked them.
"I hope this is the start of a candidconversation about Obamacare’s shortcomings," Senate Minority Leader Mitch McConnell said in a statement reacting to Burwell's nomination last Thursday.
About eight in 10 voters say a candidate's stance on the law will be important when they vote this November, according to a new Pew Research-USA Today poll released last Thursday. That includes more than half — 54 percent — who say it will be "very important."
The group rating Obamacare as "very important" is made up of many enthusiastic Republicans as well as Independent voters. By nearly a 2-1 margin, those who say the law will be "very important" in determining their vote disapprove of Obamacare.
Sebelius' resignation and Burwell's subsequent nomination can help keep the law in the news.
At the Freedom Summit on Saturday, Texas Sen. Ted Cruz said Sebelius' resignation served as the "latest reminder of the disaster of a failure that has been Obamacare." He also suggested this was a chance to re-examine Obamacare, and he used it as another opportunity to pledge Republicans would repeal "every single word" of the law.
"I think the reason Kathleen Sebelius resigned is that Senate Democrats are running scared," Cruz said. "They're terrified of how badly the harm Obamacare is causing millions of Americans, and they're looking for a scapegoat. They want to put Obamacare behind them, but the answer is not simply having one person resign. The answer is for congressional Democrats to realize this thing isn't working."
Tennessee Rep. Marsha Blackburn suggested Senate Republicans grill Burwell on enrollment numbers and the "math" of the law in an interview with Business Insider at the summit Saturday. Blackburn said Obama's selection of Burwell was a signal the administration "knows it has a math problem," hinting she doesn't believe the administration's figure of 7 million Obamacare enrollees.
"They know that their numbers are not going to work," Blackburn said. "They know something about that 7 million people who have gone to the website and supposedly signed up. They are realizing they are going to have to be spinning this. Whether it is not all of them have paid, or too large a number got subsidies, or there are too many Medicaid enrollees, or there are not enough young enrollees, in actuality, this is not going to be sustainable."
WASHINGTON (Reuters) - Americans increasingly think Democrats have a better plan for healthcare than Republicans, according to a Reuters/Ipsos poll conducted after the White House announced that more people than expected had signed up for the "Obamacare" health plan.
Nearly one-third of respondents in the online survey released on Tuesday said they prefer Democrats' plan, policy or approach to healthcare, compared to just 18 percent for Republicans. This marks both an uptick in support for Democrats and a slide for Republicans since a similar poll in February.
Secretary of Health and Human Services Kathleen Sebelius stepped down last week after overseeing the law's rollout, including the HealthCare.gov website's tumultuous first weeks, when many users were unable to access the system to purchase or research their insurance options.
But a surge of late sign-ups for health coverage pushed the number to over 7.1 million people by the end of March, and Sebelius said before resigning that more than 7.5 million were expected to sign up this year.
"In the last couple of weeks, as the exchanges hit their goals, news coverage has been more positive and the support of the Democratic Party on this issue has rebounded," said Ipsos pollster Chris Jackson.
"It's not that independents are moving their way, it's that Democrats who had previously been a little bit ambivalent in their support are coming back to the party," he said.
One-fifth of respondents said they did not know which party had a better plan, and another fifth said neither party did.
Republicans and Democrats are facing off over President Barack Obama's signature healthcare law ahead of November's congressional elections, when Republicans are looking to reclaim control of the U.S. Senate and bolster their advantage in the House of Representatives.
Opposition to the Affordable Care Act is a central theme in many individual campaigns, and national Republicans have promoted ending the law as the most important issue at play in the elections.
While Democrats have struggled with the law's unpopularity, Republicans have faced criticism that they do not have any reasonable alternative to Obama's healthcare plan.
"Democrats have not managed to have a huge lead over Republicans so much as Republicans have managed to damage their own position and stay behind Democrats," Jackson said. "That's because people don't view the Republican Party as standing for any particular healthcare system."
In a February poll, just around one-quarter of respondents said Democrats had a better plan. That number increased to 31 percent in March and 32 percent in April.
Republicans' healthcare plans had the backing of 24 percent of respondents in the March survey, 6 percentage points higher than their April support.
Ipsos polled 799 Americans online from April 6 to 15. The poll had a credibility interval - a measure of precision - of 4 percentage points.
The rate of uninsured is dropping significantly more in states that have set up their own insurance exchanges and have expanded the federal Medicaid program, according to a new survey from Gallup released Wednesday morning.
States that had chosen to set up their own exchanges and expand Medicaid already had lower uninsured rates to begin with, but the new data shows the disparity widening.
According to the data, the uninsured rate in states that have both set up their own exchanges in the health-insurance marketplace and expanded Medicaid dropped to 13.6% in the first quarter of 2014. That was a 2.5% year-over-year drop.
But the rate of uninsured in states that have either not set up their own exchanges or expanded Medicaid stands at 17.9%. That's only a 0.8% decline from the same first-quarter period last year.
Overall, 24 states have declined to expand the Medicaid program. Only 17 states and the District of Columbia have set up their own exchanges.
Here's a chart from Gallup:
The Congressional Budget Office said Monday about 12 million net people had gained insurance coverage through programs established by the Affordable Care Act, including federal and state insurance marketplaces and Medicaid expansion. The expansion of Medicaid accounted for about 7 million of the gains. A RAND Corp. study released last week said about 6 million net people had gained coverage through Medicaid expansion. According to the CBO, the uninsured rate fell to 16%.
The CBO also projected 19 million people will gain coverage by 2015, 25 million more by 2016, and 26 million more by 2026. The CBO also projects 19 million people will gain coverage by 2015, 25 million more by 2016, and 26 million more by 2026.
The Obama administration has spent much of the past two weeks trumpeting the law in spite of a disastrous rollout. Former Secretary of Health and Human Services Kathleen Sebelius, who resigned last week, said 7.5 million people had enrolled in plans through the exchanges by the end of the law's first open-enrollment period on March 31.
The 8 million figure significantly surpassed expectations from original predictions — the Congressional Budget Office predicted last year that 7 million would enroll by the end of the first open enrollment period. After a flawed and disastrous rollout, the CBO revised that number down to 6 million. The final number ended up at more than 8 million because of an incredible surge over the last month, and there's one stat that shows just how dramatic that final wave of enrollment was:
On the last day alone, about217,000 people signed up— more than twice as many as signed up during the entire month of October.
That momentum carried into April, when people were allowed to continue signing up for insurance plans if they had started the process before the original March 31 deadline.
The Obama administration didn't release a full breakdown of the final month-by-month totals, but one success story comes from California, which can be viewed as a bellwether nationally. According to Covered California, about 205,000 people were able to finish their applications and sign up from the April 1-15 period — including a record of more than 50,000 on April 15. The 205,000 number represents about 15% of California's total sign-ups.
Here's a look at the month-by-month progression in California:
"This law is working," Obama said at the press conference. "This law won't solve all the problems in our health care system. We know we've got more work to do, but we now know for a fact that repealing the Affordable Care Act would increase the deficit, raise premiums for millions of Americans, and take insurance away from millions more."
Oracle was the state's primary contractor hired to build the website.
Oracle has so far refused to comment publicly. Now, a letter from Oracle's President Safra Catz to Cover Oregon has surfaced giving insight into what Oracle thinks about the whole thing, reports Jeff Manning at the Oregonian
The upshot: Oracle blames the state for mismanaging the project, particularly for its decision not to hire what's known as a systems integrator, or a tech consultant that builds computer systems by combining hardware and software from lots of different tech companies.
Catz has also offered an olive branch: "We encourage Cover Oregon to immediately hire a systems integrator to lead the project, as it represented it would do in the first place," she said in the letter.
Oregon's website was supposed to be the crown jewel of state health insurance exchanges. It was to be the model by which other states could build their own. Now it's the poster child of the awful technical rollout of Obamacare. It has been called "the worst disaster zone" of state exchanges by the Washington Post's Ezra Klein.
The site has cost $200 million so far, with more than $130 million going to Oracle. Oracle wants to charge still more reports Manning.
After missing deadline after deadline, the site is limping along today, requiring people to use paper forms for at least part of the application process. All told, about 217,000 Oregonians have enrolled in coverage through Cover Oregon, reports the Statesman Journal. Work on the website continues.
Like all massive IT projects that spiral out of control (and research shows that 66% of them do), the truth is there's plenty of blame to go around.
NEW YORK (Reuters) - Americans with accounts on President Barack Obama's health insurance enrollment website, HealthCare.gov, were advised that their passwords had been reset to guard against the "Heartbleed" bug, in a message posted on the site on Saturday.
The warning marks the latest fallout from the widespread security bug, which surfaced this month and allows hackers to steal data online without a trace. Companies from Amazon.com Inc to Google Inc. have been forced to take steps to protect against Heartbleed.
A message on HealthCare.gov said users who visited the website would need to create a new password to access their accounts.
"While there's no indication that any personal information has ever been at risk, we have taken steps to address Heartbleed issues and reset consumers' passwords out of an abundance of caution," said the message posted on Saturday.
The Heartbleed security flaw is a "catastrophic bug" believed to affect two out of every three Web servers, according to the Electronic Freedom Foundation.
HealthCare.gov, a health insurance exchange for the 36 states that opted out of creating their own state insurance exchanges, was created under Obama's signature health care law, the 2010 Patient Protection and Affordable Care Act.
The website's launch last fall was dogged by complaints that many users could not access the site to buy insurance or research healthcare plan options. Most of the website's most prominent flaws were eventually remedied.
Obama on Thursday announced in the White House briefing room that 8 million people had signed up by the latest enrollment deadline of April 15. The program's original goal was 7 million signups by the end of March, which was met.
Republicans have been relentless in their criticism of the healthcare law ahead of November's congressional elections, when the GOP hopes to reclaim control of the U.S. Senate and strengthen its majority in the House of Representatives.
Critics of Obama's health initiative have suggested HealthCare.gov might be vulnerable to security flaws.
The Heartbleed bug exploits a glitch in a widely used Web encryption program known as OpenSSL.
It has not affected only corporations.
Canada's tax-collection agency said this month that the private information of hundreds of people had been compromised as hackers exploited the Heartbleed bug.
(Editing by Alex Dobuzinskis; Editing by Clarence Fernandez)
In a lot of ways, for a lot of Americans, the Affordable Care Act, aka Obamacare, has delivered precisely what its official moniker suggests: affordable health insurance.
Speaking on a purely personal level, the plans I could buy post-Obamacare carried monthly price-tags ranging from $350 to $700 – a far cry from the solitary plan available to me before, priced at $1,785 a month.
And yet, the cost of staying healthy isn’t always picked up by your health insurance company.
Under Obamacare, Americans may no longer have to choose between bankruptcy and getting medical treatment for life-threatening illnesses. But the burdensome costs of the routine stuff could become still weightier.
Family members might once have been covered as part of a benefits package but now were covered at additional cost; employees were told they’d be picking up part of the cost of some of the plans (especially “extra” benefits, like dental or vision plans). As the years have passed, benefits themselves have become leaner, as both employers and insurers have sought to cut expenses.
Just ask Rita Cheng, a financial advisor at Blue Ocean Global Wealth in Bethesda, Maryland. She helps her clients cope with their rising costs – including medical expenses – and deals with the financial impact of her 15-year-old son’s chronic asthma.
“The co-payment for the inhaler he needs for his maintenance – to prevent a severe attack – used to cost me $7,” she says. “Then it went to $30. Then $60. Now it’s $100, every month.” In other words, she is now paying more than half the cost of the medication, with her insurance picking up the remaining $81.
“It’s not as if you have a choice about whether or not to use an asthma inhaler,” she points out.
Ironically, Obamacare may only have made matters worse for the cost of day-to-day healthcare including vision and dental plans.
People like Cheng who know that they’re going to be forking over a lot of money for stuff that isn’t covered by their insurance plan – co-payments, deductibles, or treatments after you’ve reached your annual maximum – can use pretax dollars from their paychecks to set up either a health savings account (HSA) or flexible spending account (FSA).
(Here's the difference in a nutshell: employers have the option of offering an FSA; if they don’t and you’re enrolled in a high-deductible health plan, you can set up your own HSA.)
Pre-Obamacare, there wasn’t any official maximum limit to FSAs. A number of employers set the contribution as high as $5,000.
So if you knew you’d be forking over a lot for your teenager’s braces, your husband’s dental work and your own arthritis medications, and that changes to your health plan meant you’d be shouldering more of the burden for routine office visits to doctors, you could set aside $3,000 or more.
“With the arrival of Obamacare, I am seeing more complexity, including people finding that their longtime physicians are now out of network and have to be paid out of pocket,” Cheng notes.
It all adds up. For me, that means discovering that in my new network, there isn’t a single neurologist in my new network who is accepting new patients.
I’ve now found a great out-of-network doctor, but I’ll pay $2,000 a year on top of my new, affordable, Obamacare healthcare premiums to consult him. And let’s not even talk about the fact that the typical dental plan’s benefits max out at about $2,500: if you need two root canals, you’re done for the year (and you’ve probably still paid $1,200 out of your own pocket).
Heidi Leighton, a Maine office worker, already rations the frequency with which she takes Trexemet, the medication she uses to control her migraines. “It costs $5 a pill, and there’s no generic yet,” she says.
She frets about having to take a day off work to travel two hours each way to Bangor in order to have medically-necessary bloodwork at an in-network hospital. (She could have it done locally, and not lose a day’s wages – but then she’d have to pay $100 out of pocket.)
But it’s the insurance company’s policy on orthotics that really annoys her.
“As a child I had foot surgery to separate small bones that had fused together and now I need custom orthotics” in order to be able to stand without pain and remain physically active, even mobile. That’s about $120 a year – and the insurance company won’t pay a dime, even though without them Leighton risks ending up on disability.
“Any one of these costs on its own is no big deal, but if you add them up, it’s bad news, even though it’s somehow it’s never quite enough to qualify as a deduction against our income taxes.”
For many Americans, it’s going to feel as if new costs are sneaking up on us as a result of Obamacare in part, says Eleanor Blayney, consumer advocate for the CFP Board. It mandates that health insurance policies cover things that once weren’t required, like alcohol counseling or treatment for obesity. Women may end up getting a greater array of obstetrical and gynecological care and procedures covered, while children up to the age of 26 are covered.
“So as the costs of those requirements are priced in, other cuts may show up,” says Blayney.
Employers may decide not to cover healthcare for spouses; they may not offer dental policies or vision care, or may no longer subsidize those plans. UPS has already made headlines because of its decision to yank healthcare coverage for its employees’ spouses.
Clearly, “affordable” is all in the eyes of the beholder.
There were two major takeaways from this week's big Obamacare announcement: The first was that more than 8 million people had signed up for insurance through federal and state exchanges. The second was that 28 percent of those people who enrolled via the federal exchange were in the 18–34 bracket, the much-coveted demographic the industry has branded the "young invincibles" because they've typically gone without coverage out of a (highly questionable) belief that they just won't get sick.
As I explained, it's difficult to look at the 8 million figure and see it as anything but a success; the open enrollment total now sits comfortably above even the original CBO projection of 7 million. Despite all the handwringing and bad press that was caused by healthcare.gov, the White House can now say it didn't just live up to open enrollment expectations, it exceeded them.
The second figure, that 28 percent, is a good deal harder to place on the failure-success spectrum. (The demographic is so important because the young, presumably healthy, are supposed to help offset the costs of older, typically sicker Americans who are also in the same risk pools.) The back-of-the-envelope math that had been used by those following the enrollment figures closely was pretty simple: Young Americans represent about 40 percent of uninsured Americans, so in an ideal world they'd also represent the same chunk of the total Obamacare enrollees. (In the months before the open enrollment period, the White House had suggested they were hoping for that mix as well, or about 2.7 million of the original 7 million projection.)
I don't need advanced math to tell you that 28 percent is less than 40 percent. So by that metric, the White House's Two Ferns-themed youth outreach came up well short, even though the final percentage of young enrollments was about 4 percent higher than it was during the early returns. So just how worried should the White House and its ACA allies be? It's tough to say. We're still waiting on the state-by-state breakdowns, which are actually more important than the national numbers. But in the meantime the New Republic's Jonathan Cohn offers up a noteworthy data point that should offer some degree of comfort to those hoping the law works as planned:
Only company officials know exactly what they were projecting—that’s proprietary information—but one good metric is the signup rate in Massachusetts, in 2007, when that state had open enrollment for its version of the same reforms. According to information provided by Jonathan Gruber, the MIT economist and reform architect, 28.3 percent of Massachusetts enrollees were ages 19 to 34, a comparable age group.
Yes, that's right: The overall age mix for the Affordable Care Act is virtually the same as the age mix was in Massachusetts. More important, it vindicates the predictions of experts like Gruber who said, all along, that young people would be among the last to sign up. "To get to 28 percent overall, there had to be a lot of young people among the late enrollees," says Larry Levitt, senior vice president at the Kaiser Family Foundation. "That also bodes well for who is likely to sign up next year."
That optimism aside, clearly the administration was hoping more young/healthy Americans had signed up during the initial open enrollment period. There's a reason why Obama gave the 8 million figure top billing at yesterday's press conference, and why he blurred the young enrollment figure somewhat by talking about the percentage of enrollees under 35—a group that includes children under the age of 18 who are on their parents' plans—and not the more important 18–34 numbers. For now we'll have to wait and see what impact the young-old breakdown has on premiums.
This could get awkward. Since wrapping up his tenure as Florida governor seven years ago, Jeb Bush has been quietly building a fortune for himself, raking in millions of dollars from consulting gigs, real estate investments, and that staple for out-of-office politicians, speeches.
Yet Bush has also netted more than $2 million from his work as a board member with Tenet Health Care,according to The New York Times' Michael Barbaro. That tie could prove troublesome for Bush if he runs for president in 2016 because Tenet, Barbaro writes, "aggressively encouraged Americans to sign up for insurance under the [Affordable Care Act] and trumpeted the legislation as a boon to the company’s finances."
Though Bush is no fan of the law — he once called it "flawed to its core"— his association with a group that effusively endorsed it could be a stain on his resume. ObamaCare is such an anathema to conservatives and the Tea Party that there are efforts afoot to oust members of the party leadership who refused to play along with the government shutdown last year in an ill-fated attempt to defund the law.
That anger on the right could subside somewhat come 2016, especially if ObamaCare continues to enroll people in bunches. Still, it's not hard to imagine Bush's GOP opponents, should he run for president, ganging up on him for his association with Tenet, much like Mitt Romney's foes beat up on him for signing off on Massachusetts' health-care overhaul.