It’s not a total disaster. At least the White House can say that with a straight face.
Hitting the threshold of 6 million enrollees gives the Obama administration a plausible basis for saying the Affordable Care Act is working more or less as expected. But it’s far too early to call Obamacare a success and in at least one important way—public opinion toward the law—it’s a failure, as Lauren and I discuss in the video above.
The nonpartisan Congressional Budget Office originally estimated that 7 million Americans would enroll in Obamacare, as it’s known, during the law’s first full year in effect. The CBO downgraded that estimate to 6 million after the botched launch last fall made it hard to enroll. With the April 1 open enrollment deadline near, hitting the reduced estimate for 2014 amounts to a weak passing grade in Obamacare’s first semester.
With 6 million enrolled, the ACA will probably reach the critical mass needed for the basic economics of the program to work. Insurance companies will get enough new customers to pool healthcare costs effectively, the way insurance is supposed to work. A long list of questions remains unresolved, however. Though 6 million have enrolled, a smaller number will follow through by paying their premiums and actually purchasing insurance. So the final number of 2014 enrollees could still fall short of estimates. And it’s not clear if the mix of healthy and unhealthy people is balanced enough to prevent big premium hikes in the future.
The more troubling problem may be the persistent unpopularity of the law. The launch of Obamacare last fall was an opportunity for the program’s backers to overcome three years of rhetorical hostility toward the law and show that, once implemented, the law was less problematic and more beneficial than critics warned. We know what happened instead: seemingly everything that could go wrong did, several million Americans lost insurance plans they were comfortable with, and Obama was forced to make several changes to the ACA that looked like backpedaling.
The law certainly has helped a significant number of people who didn’t have insurance before get it. The problem is that Americans aren’t convinced the law has done more good than harm. A Gallup poll shows that 48% of Americans think Obamacare will worsen the healthcare situation in the United States, while only 35% think the ACA will improve it. And opposition to the law has grown, not shrunk, since it went into effect last fall. It’s hard to think of a major program opposed by more than half the population that survived for very long.
The midterm elections in November will serve as a referendum on Obamacare more than anything else. Maybe, by then, the controversial headlines will have subsided and support for the law will be growing. Still, Democrats who supported the law would be wise to develop a backup plan.
Rick Newman’s latest book is Rebounders: How Winners Pivot From Setback To Success. Follow him on Twitter: @rickjnewman.