The ongoing efforts by the Obama administration and their media apparatchiks to boost the “soaring" enrollment figures of ObamaCare have hit another bump in the road. Despite administration’s highly dubious figure of eight million enrollments, the latest McKinsey survey tracking the health insurance market’s first open enrollment period reveals that a staggering 74 percent of those who signed up for the plan were previously insured. Furthermore, McKinsey "confidently” states that only 1.7 million enrollees were previously uninsured and another 865,000 purchased coverage off the exchanges. Thus, Americans have endured a complete upheaval of the nation’s healthcare system to provide coverage for only 2.6 million additional individual market enrollees.
And as most Americans know, the eight million touted by the administration as enrolled makes no distinction between those who have “signed up” for Obamacare, and those who have actually paid for their plans. McKinsey puts the percentage of those who have actually paid their first month’s premium at 83 percent.
What a lot of Americans don’t know is that a number of enrollees are duplicates, due to ongoing problems with the “back end” of the Healthcare.gov website, which still remains under construction. Thus, people who were unsure if they initially got coverage were encouraged to go through the process a second time. How many of those “double enrollees” were counted twice remains a mystery.
But perhaps the most glaring reality omitted by ObamaCare’s cheerleaders is this: they are touting the success of a plan that Americans are required to purchase, lest they face IRS scrutiny and/or a fine for failing to do so.
Nonetheless, this so-called success is what prompted President Obama at an April 17 press conference to announce that "the repeal debate is and should be over,” and that ObamaCare "is working.” The president was aiming his remarks at Republicans, belittling them in the process. "I recognize that their party is going through the stages of grief—anger, denial, all that stuff," Obama smugly declared. "We're not at acceptance yet.”
Despite the president’s arrogance, the American public, a far more important component in this equation than the GOP, is not “at acceptance yet” either. A Washington Post-ABC poll conducted in April reveals that 29 percent of the public believes the quality of care they receive is getting worse, compared to only 14 percent who believe it is getting better, a more than two-to-one margin. A majority of Americans believe it has stayed the same.
Nearly the same two-to-one margin, 44 percent to 24 percent, applies to Americans who believe the the entire nation’s healthcare system is getting worse, with only a third saying it is staying the same. Cost comparisons are also bleak, with 47 percent saying healthcare costs have increased, compared to only 8 percent reporting cost decreases. Similar percentages apply to the entire nation’s healthcare costs, with 58 percent of Americans seeing increases, compared to 11 percent who see decreases. Yet perhaps the most important question in this survey asked Americans if they approved of the way Obama was handling the implementation of the law. A whopping 57 percent disapproved, compared to only 37 who approved. One thing is clear: all of the above makes an utter mockery of the idea that the ObamaCare debate is over.
And why should it be? Even before the president unilaterally postponed business mandates that threaten million of additional Americans with policy cancellations take effect, the string of broken promises attached to the healthcare bill remain inarguable. Despite the promise to “bend” healthcare costs down, ObamaCare is expected to increase healthcare spending by 6.1 precent this year, compared to a growth rate of less than 4 percent the previous four years. Two-thirds of businesses that currently offer health insurance to their workers will see increases as well, according to the Centers for Medicare and Medicaid Services (CMS).
Nor did premiums drop by $2500 for the “typical family" as the president promised—when he wasn’t busy promising Americans who got insurance through their employer that their premiums could drop by as much as 3000 percent. In fact, according to health industry officials interviewed in March, premium costs will double in some parts of the country next year. As for jobs, the Congressional Budget Office (CBO) projected in February that the reduction in the the total number of hours Americans work due to ObamaCare will be equivalent to a 2.3 million reduction in full-time jobs in 2021. The CBO had previously estimated a workforce reduction equivalent of only 800,000 jobs. If such revisions have a familiar ring, maybe it’s because Democrats’ initial promise that ObamaCare would only cost $848 billion over a decade was as empty as any of the others: ObamaCare’s ten-year cost estimate now surpasses $2 trillion.
And who can possibly forget the most glaring "broken promise" of all, more accurately referred to as Politifact’s 2013 Lie of the Year -- President Obama’s oft-repeated contention that Americans can keep their insurance policies and/or their doctors and other healthcare providers?
Yet the fundamental flaw in the whole enterprise is best described by National Review’s Ramesh Ponnuru who notes that "the picture of Obamacare today looks more like one the critics painted than the one supporters did: a lot of trouble for a small gain.”
Yet even those small gains may be ephemeral. As Bloomberg News revealed last October, there is an "accelerating trend" of healthcare providers demanding upfront payments for non-emergency care as insurance deductibles rise. That trend will undoubtedly be exacerbated by ObamaCare, due in large part to a provision in the law that provides enrollees a 90-day grace period of premium nonpayments before their insurance can be cancelled—even as the insurance companies themselves remain liable for payments to providers for only 30 of those 90 days. The remaining 60 days leave the provider on the hook for collecting their fees. Furthermore, the aforementioned small businesses looking at rate increases may decide to drop coverage altogether, putting another 20-30 million Americans in the same boat as the 5 million Americans who had their policies cancelled because they failed to meet the new requirements.
Another trend likely to accelerate is the narrowing of provider networks, as insurance companies strive to contain costs by eliminating more doctors and healthcare facilities from the list of options provided to enrollees. Lawmakers in many states are looking for ways to force insurers to expand those networks, and a federal proposal aims to give the CMS the power to require insurance companies to provide a full list of providers in a network. But as mentioned above, that in turn is likely to push overall premium costs higher.
As the McKinsey study notes, this also does not bode well for the future. Despite an increase of previously uninsured respondents shopping for insurance from 44 percent to 61 percent between their February and April surveys, McKinsey notes that only 21 percent of those shoppers reported enrolling in plan. This rate is far lower than the one for those who had insurance before ObamaCare became the law of the land.
The most prevalent reason cited for exiting the purchasing process? Perceived affordability, with the highest percentage of those refusing to buy being "previously uninsured and subsidy-eligible.” This means a plan primarily designed to attract more lower-income Americans who have never had health insurance due to affordability issues isn’t living up to expectations.
Moreover, Americans should never forget that all of this is happening even as two other major variables remain unresolved. First, the mechanism for a taxpayer bailout of insurance providers remains in effect. These so-called “risk corridors” allow providers to set their premium prices artificially lower until the end of 2016. After that, without underwriting by the federal government, premiums could skyrocket even higher. Second, the employer mandate affecting mid-sized companies with 50 to 99 full-time employees, and larger companies with 100 employees or more, has been postponed until 2016. It remains to be seen how many more policy cancellations will result when Democrats can no longer kick that politically-charged can past another election cycle.
Washington Post columnist Charles Krauthammer sums up the entire picture as it currently stands. "Everybody is getting a worse deal,” he contends. "If the providers are, that means the doctors aren't getting their usual payments, which means they have to see much more patients, which means they spend less time, which means the care is inferior, that means they are reimbursed at a lower rate, which means some of them will go out of business.”
He also addresses the president’s unseemly spiking of the ObamaCare ball. "Which is going to have more effect on the voter--Obama in a press conference in a holiday week throwing out a number, 8 million, which means nothing?” he asks. "Or knowing someone in your family, or you, losing health insurance, having your hours reduced so your employer can call you part-time—losing your job, losing hours--all of this stuff affecting you personally?
No matter how one answers those questions one thing is certain: America has a long, long way to go before any debate regarding ObamaCare is over.
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