STUMP » Articles » Obamacare Watch: 10 March 2014 -- Holding Them To It » 10 March 2014, 05:41

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Obamacare Watch: 10 March 2014 -- Holding Them To It  


10 March 2014, 05:41

You will see that some of my old Conservative Commune posts will be popping up in the archives, as Stu ports them over for me and I edit them so they work here.

One that has yet to come over is from October last year, in which I noticed the Brookings Institution (via Ezra Klein) laid out the metrics by which they thought Obamacare should be measured. Or, rather, quantifiable questions that should be asked, and there was an obvious direction for the “correct” answers.

Here are the eight questions, plus one extra from Ezra Klein

1. Is there a reduction in the total number of uninsured?

2. Is there an increase or stabilization in the cost of premiums on the exchanges and in the private market?

3. Is there an adequate number of plans in the exchange and does the number increase or decrease over time? Are plans exiting or entering the market over time?

4. Does the number of people who pay the penalty for not having insurance increase or decrease over time?

5. Is there a decline in employer coverage?

6. Is there a decline in full time-work and an increase in part-time work?

7. What is the extent of the conflict between federal and state oversight of health insurance and does it increase or decrease over time?

8. Is there evidence of an increase or a decrease in out-of-pocket expenditures on health care?

I’d add one question and one caveat.

First, the question: Is the growth in national health expenditures above or below trend? As one of the law’s architects pointed out to me on Tuesday, the early take on Obamacare was that it was going to be a major success in expanding access but it didn’t do enough to control costs. So far, however, the access expansion has been more troubled than most expected, while cost control has been far more of a success than anyone anticipated. That’s a trend worth following.

Second, the caveat: Short-term problems can become long-term problems. Take the difficulties accessing the federal exchanges. If those persist much longer, it could change the mix of people who ultimately sign up.

Nice to have given himself an out (the post was October 16).

While they are not necessarily the metrics I would have picked, I think these are reasonable to ask. I know they are saying these are long-term questions, but the short-term looks very bad indeed.

Megan McArdle explains

Half of uninsured adults have looked for insurance online, according to an Urban Institute survey cited in the Washington Post. But only 10 percent of them have actually bought it, according to a different survey from McKinsey & Co. Overall, McKinsey says, just one quarter of the people who bought insurance on the exchange were previously uninsured.

The positive way to look at this is to note that the number of uninsured people who had purchased insurance increased dramatically by February:

The negative way to look at this is to note that, even so, the majority of activity in the market comes from the previously insured, who are mostly replacing prior coverage.

With one month to go, most of the uninsured still hadn’t done anything. Worse, the number of previously insured people who had not enrolled in a qualified health plan by the end of February was almost twice the number of previously uninsured people who had. That’s the opposite of the effect this law was supposed to have.

This is my shocked face :-|

It’s worse than it looks. Note how many people renewed the coverage they already had — now, perhaps some of them had coverage in compliance with Obamacare requirements, but let’s face it, not many old insurance policies were issued with community rating and the age-rating restrictions that make health coverage “cheaper” for older, sicker folks and much more expensive for younger, healthier men.

Some of those who did not renew weren’t allowed to renew. There’s this somewhat silly lawsuit in California which seems just to be political grandstanding to me. IANAL, but I’m wondering exactly what the basis for suing over non-compliant policies not being extended.

Politician: How dare you cancel these policies!

Covered California: but under PPACA, they’re not compliant!

Politician: but Obama said it didn’t matter!

Covered California: that’s nice, but we’re in court, and what is relevant is the actual law. No matter how much Obama, et al, are trying to change it by fiat after the fact.

Politician: VOTE FOR ME !!!!1!!!eleventy!!!!1!!!

I assume that’s the thinking. I have sympathy for the people caught in this half-assed implementation (yes, yes, I know they’re using their whole asses. And sometimes their derrieres), but pretty much everyone is getting caught in it. It’s going to take a lot of people getting extremely pissed off for Obamacare to be outright repealed, because Harry Reid would not only have to lose the Senate majority leader seat (pretty good chances of that), but enough people need to be in both houses to overturn an Obama veto.

While, OBAMACARE MUST BE DESTROYED, the best short-term bet is going to be a lot more half-assed delays and “fixes:. I think the metrics are going to show that it’s a clear stinker, no matter if you look at it short-term and long-term.

It’s such a pity how many people are going to have to be hurt before this excrescence is buried.

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