Jonathan Cohn notes that it now looks like about 6.7 million people will ultimately sign up for ObamaCare by the cutoff, which is officially tomorrow, but in reality April 15th.
Even accounting for the fact that some of these people won’t actually pay their premiums, these figures would seem to undermine—or at least weaken—the argument that Obamacare is a catastrophic failure. Republicans and many of their allies obviously think otherwise. They are doing what they almost always do when data confounds their previously held beliefs. They are challenging the statistics—in particular, by suggesting that most of the people getting insurance already had coverage. Some, like Senator John Barrasso of Wyoming, say the administration is “cooking the books.” Others, like Senator Ted Cruz, say that the number of people without insurance is actually rising.
Sorry, but that’s nonsense.
Over the weekend, the White House press office proudly blasted out this blog post showing the long lines that had formed all over the country of people seeking ObamaCare. As an aside, the White House web site is brazenly sticking it to the Republicans by displaying a countdown clock that says that there are still 16 days to sign up.
The best estimates are that the law is roughly where it was expected to be, both in terms of how many people signed up and in how much it has so far reduced the ranks of the uninsured (about a 23% reduction).
Obviously, it would be over-performing if the website had functioned properly from the outset and, especially, if the Medicaid expansion hadn’t been undermined by the Supreme Court and ideologically-mad Republican governors and legislatures.
Maybe I am misunderstanding, but does it even matter if “most of the people getting insurance already had coverage”?
My brother in law was going to sign up this weekend. I will be curious to see what kind of results he ends up with. I expect that due to his low income that he will qualify for subsidies and, in the end, get a pretty good deal. He is in his 50’s and, in the 20-plus years I have known him, has never had health insurance.
My dad, who is on Medicare, told me yesterday that he is losing one of his specialists, “due to Obamacare”. His doctor told him that, “due to the excessive paperwork that is now required of him, he cannot afford to hire the additional people necessary to meet those paperwork requirements. So he says he is having to drop all of his Medicare patients, accepting no new non-Medicare patients, cutting back to 2 days a week and he is going to have to quit practicing 7 years prior to when he had planned. And this is all due to Obamacare.” Now, my Bullshit Detector is going off the scale as he is telling me this. But there is really no sense in even trying to filter through all this with him, anyway. Everything the doctor told him is exactly what my dad is wanting to hear. Is it fact, fiction or a little of both??? It’s impossible for me to ever know.
Well, if your goal is to insure everyone, then counting people who have simply changed plans would be deceptive. That’s the idea behind what the GOP is saying.
I’d be interested to hear what paperwork is required of doctors due to ObamaCare. It’s insurance, just like the insurance that doctors were taking last year.
No, it’s not impossible. Since “Obamacare” works through private insurers, what extra paperwork do doctors have to submit? The answer is none. And since the ACA specifically requires companies and providers to digitize and standardize their billing, there’s likely to be less, not more paperwork in doctors’ offices. Furthermore, the insurers receive the subsidy from the government directly so those companies are responsible for any subsidy-related paperwork. The providers are not involved in that.
The specialist’s claim that s/he’ll have to cut-back to 2 days/week because of the ACA is ridiculous on its face. What ACA provision makes that a cost-effective choice for any doctor concerned about profits? If the Medicare reimbursement is reduced and s/he’s concerned about profits, that means working more hours, not less. Unless the specialist is prepared to only accept direct payments, s/he’ll have to deal with the insurance companies. Of course, s/he has a choice about participating in particular networks but until the insurance companies reject Medicare patients, I’d say this specialist is lying like that Boonstra woman in MI.
As to anyone’s speculative claims about what “-will be necessary 7 years from now,” they are just that…speculative. No one knows what the ACA will look like after the Democratic landslide in 2016.
As the comment by rfahey below indicates, there is often some small shred of truth, possibility or nuance to stories such as what were told to my dad. And since it is impossible for me know what was truly told to him by that specialist, then there isn’t much of a way for me to make an informed response to what he was told, which can directly refute his claims. Not that he would ever be convinced that Obamacare is anything except the end of the world as we know it.
Of the few doctors I have talked to, a lot seem to have mixed feelings about the whole thing, though almost all are willing to just see how things play out. None has depicted it as something which will drive them from the practice of medicine, like many of the horrific scenarios painted by the right wing noise machine. And while, for some, the digitizing of medical records is a logistical pain, they all say that it is a good thing. And I have seen that in my own recent health issues, where every doctor I have seen can just bring up my entire medical history from every specialist, including notes and thoughts about my medical issues.
So while I personally feel that Obamacare will be positive sea-change in the well being of our nation, I still struggle with the constant stream of misinformation that gets thrown in my face every freaking week about it. You cannot possibly address, in simple responses, the mis-characterizations that are fed daily to people like my dad. Here in our state, we are tirelessly working to address our Governor’s voter suppression tactics and, without fail, when you try and engage people on that topic, you end up getting these credulous Obamacare nightmare stories thrown at you, instead. It just taxes your mental strength.
In one of the Obamacare “horror stories” it turned out to be about the required digitizing of records that the dr. wasn’t prepared to/ didn’t want to do. Might be that
The ACA will direct physicians to recognize that a patient’s care relies on a team effort; the use of the MyChart and online records is geared towards managing, as a team, a patient’s care. There’s even a 10% bonus for patient care well. From what I can see, much of the doctors’ complaints come from the job of moving a practice into the electronic world.
For many physicians the overhaul of a system where one didn’t share information with other doctors readily (ask anyone who’s had to get a 2nd opinion how hard it is to transfer records) or didn’t recognize something as simple as answering a faxed question, an email or a text from a patient as a way of managing care this new way may be daunting. But it’s all in the patient’s best interest.
A better explanation
And it’s long, long overdue. Lack of it contributes significantly to substandard care.
Maybe a little of both, mixed in with some misunderstanding of what the specialist said? It’s true that payments to doctors have been changed under Obamacare and that certain procedures will pay less going forward. Which, you know, sort of sucks if you’ve chosen to specialize in the affected procedures and have a few hundred thousand dollars in medical school debt to pay off (or a house, or a family to feed, or whatever).
My wife’s a cardiologist and is somewhat sanguine about the changes being implemented (happy that more people are being insured, sad about the mountain of school debt that we need to pay off and the diminished opportunities in her chosen field). I could never accurately summarize the changes that are happening to the medical profession as a result of the law, but it will adversely affect some specialists.
every story about Obamacare should include mention of the FIVE MILLION AMERICANS that are being denied healthcare BECAUSE OF GOP GOVERNORS.
Oh, but that would be all partisan and not balanced and stuff, so our crack journamalists can’t do that, no way.
Enrollments are working fine and thanks to Charles Gaba we have some measure of it. We have to remember though that despite these numbers, the data behind it is very messy and Gaba’s numbers don’t include most off-exchange purchases. I like Kaiser’s remarks for weaving in some of the many situations these numbers are supposed to cover:
So we’re doing fine. The original May 2013 projection was for 7 million exchange signups for insurance (not incl. medicaid) and after problems in the fall was lowered to 6 million in Feb 2014.
One small matter about the CBO estimates that I think gets overlooked is that the projections were for signups throughout the entire year of 2014 and not just the open enrollment period. There is no “deadline” date on the original CBO reports. It simply states the projection for each year.
I’m going to ask supid questions: why is there a cutoff date for enrollment?; why wouldn’t someone be allowed to enroll later, change their mind, lose income and need help? It’s not an ongoing program in the sense that Medicaid and SS are? I must be very dumb.
Cut-off is for open enrollment, i.e., all comers no questions asked. After the cut-off, you can enroll, without penalty, if you lose your job-based coverage, get married, move out of covered area, or subsidy eligibility changes. The next open enrollment will begin on Oct.15, 2014. Those who don’t have insurance (and can’t get a waiver), will be penalized via the IRS. There’s some info here: https:/www.nyhealthinsurer.com/2014/blog/as-enrollment-period-ends-those-uninsured-pay-penalty-3
The deadline, as I understand it, is for obtaining coverage to avoid the tax penalty for not having it. You can still get coverage at any time.
In Massachusetts, if you don’t have the required coverage for X number of months, then get it to cover the remaining months, your penalty will be X/12 of the amount for going completely bare. I don’t know if that’s how Obamacare works but would suspect it is. I can’t say for sure because I haven’t Googled to check it and none of the media coverage I’ve seen explains stuff like that. They’re all too busy playing the “Who takes the political hit?” game.
The deadline is not just to avoid the penalty; it is also to access the private health insurance exchanges themselves. As mentioned above, people without insurance who have not established an account on their exchange by midnight tonight will be unable to access the exchange until late in the year.
The good news for those qualifying for the exchanges is that as long as they’ve established an account by midnight tonight they have until April 15th to choose a plan. Additionally, lower-income people eligible for expanded Medicaid in sane States can enroll at any time. Medicaid-eligible people may be subject to the small fine in their 2015 filings for no insurance it they haven’t applied by midnight (anybody know the answer to that? Is their an answer to this which applies nationwide?), but at least they can get insurance throughout the year, which in the end is far, far more important than whether they would be subject to the fine. The spectre of a potential fine does provide extra incentive to enroll quickly, however.
Thanks for the correction and further info. I made it onto Medicare in February so haven’t been paying as much attention to the details of all this as I might otherwise have.
FYI, if you know someone who is having trouble accessing the ACA website for a last minute sign up, it’s my understanding that [Health Sherpa https:/www.healthsherpa.com] is set up to select and purchase a plan.
We had two people show up at our county Dem headquarters around lunch time looking for help or advice, as they were having trouble with the website. When I left, our County Chair was still trying to help them get a handle on things.