Obamacare is in trouble again, and it will take a massive infusion of members and taxpayer money to save it.
The Washington Times reports that Obamacare exchanges will have to enroll as many as 21 million members next year, according to the figure set in budget projections, in a development that will prove to be a major test of the Affordable Care Act.
However, as of June, the Department of Health and Human Services, which oversees Obamacare, said that only 9.9 million Americans had purchased health insurance plans through the federal HealthCare.gov portal and a handful of state-run exchanges, leaving a gap of more than double the amount required in projections.
Although the 9.9 million figure is ahead of the White House’s own 2015 estimates, it is less than half of what the Congressional Budget Office projected for next year, “showing just how much work officials have ahead of them as the next round of enrollment begins in less than two months,” the paper reported.
The Washington Times further noted:
Industry analysts said the CBO’s estimate for next year is “overly optimistic” and a “stretch,” and that it will take more time for the law to attract that many people onto the Web-based markets, where consumers shop for private health care plans and typically qualify for government subsidies to reduce their monthly premiums.
“Given where things stand, the ramp-up of enrollment may be slower than initially anticipated,” Elizabeth Carpenter, a vice president at Avalere Health, a D.C.-based consultancy, told the Times.
The third year of open enrollment for Obamacare exchanges begins November 1. The Obama administration is counting on attracting millions more customers who have so far avoided signing up through an exchange in the first two years but might now be feeling pressure to do so because of the increasing financial pain of the “individual mandate” tax assessed against citizens who do not purchase a plan.
“It is definitely something that people pay attention to,” opined Rachel Klein, director of organizational strategy at Families USA, a nonprofit that advocates for affordable health care, in the Washington Times.
The so-called “tax” — which was deemed as such by the U.S. Supreme Court despite vehement denials that it was a tax by President Obama – is progressive in the sense that it rises every year. The first year, the tax was $95 or 1 percent of income above the filing threshold. However, the penalty rises to $325 or 2 percent of income this year; by 2016, it will rise to $695 or 2.5 percent of income. Keep in mind that this comes from a president and party who claim to care about working-class Americans.
“The substantial increase in penalties under the individual mandate next year is a big wild card,” Larry Levitt, a senior vice president at the Kaiser Family Foundation, a nonpartisan health policy organization, told the Times. “We’re in unchartered territory here about how effective these bigger penalties will be in nudging people to get insured.”
“The marketplaces are working,” he added, “but higher enrollment would both improve the insurance risk pool and reduce the number of Americans uninsured.”
Mandates and coercion
The authors of the law were counting on a huge influx of younger, healthier, paying customers who would then be subsidizing the cost of older, unhealthier adults, much like the current Medicare system. So far, however, the number of healthy adults who are also paying full, unsubsidized premiums has not met expectations.
In any event, congressional Republicans are still intent on scrapping the law and replacing it with something more market-based and less expensive. In the meantime, they may attempt to gut it through a fast-track budget procedure known as “reconciliation,” according to a spokesman for House Ways and Means Committee Chairman Rep. Paul Ryan, R-Wis., Brendan Buck. In particular, Buck said, repealing the individual mandate is “definitely on the table.”
“This law is only being held together by mandates and coercion, and that’s why we continue to look at ways to repeal the mandates and give people more freedom and choices,” he told the Times.
In any event, a repeal of the law might be the federal budget’s saving grace. The CBO has said that the law will likely cost less than they first projected, but that depends on a couple of factors, including the signing up of younger enrollees paying full premiums and more states opting to start Obamacare exchanges.