By Mary Agnes Carey
The Obama administration took a victory lap Tuesday as enrollment through the health law’s exchanges topped 7 million, a goal previously thought untouchable when the website healthcare.gov sputtered and crashed as sign-ups began last fall.
In a statement in the Rose Garden, President Barack Obama, said, “The debate over repealing this law is over. The Affordable Care Act is here to stay.”
But he alluded to continuing political pressure from Republicans and other opponents of the law and acknowledged challenges still remain. Although the law is bringing coverage to millions of Americans, “that doesn’t mean that all the problems in health care are solved forever.”
White House Press Secretary Jay Carney broke the news of the enrollment tally at his daily press briefing, telling reporters that the last-minute surge of traffic to the website and the call center pushed enrollment to 7,041,000, a figure that does not include sign-ups in the past few days through state-based exchanges. Healthcare.gov is managing enrollment in 36 states, while 14 states and District of Columbia are running their own exchanges.
“What was predicted to be a failure has been a success … despite the fact that we basically lost two months because of the troubles with the website,” Carney said, adding later that “we crossed one milestone here but there are many more to cross in the future.”
Carney said it is still too early to know how many enrollees did not previously have health care coverage or how many have paid their first premium, although the “overwhelming majority” of people pay premiums on time, he said. Department of Health and Human Services Secretary Kathleen Sebelius said Monday in a television interview that insurance companies estimate that between 80 and 90 percent of enrollees have paid their premiums.
The Congressional Budget Office originally projected that 7 million people would sign up for the exchanges by the end of the enrollment period. After computer problems botched the Oct. 1 rollout, the CBO revised that estimate down to 6 million. Rightly or wrongly, the ability of the law to hit that target had become a bellwether of the law’s success. But there are practical implications as well. The more enrollees there are, the more likely the risk pool will be balanced between sick and healthy individuals. That calculus will be based on enrollments at the state and local levels where premiums are set, say experts.
“Each state is its own insurance market, whether it uses the federal exchange system or not. These state differences could mean that the Obamacare exchanges are viable in some states and regions of the country, while in other states and regions the numbers remain too low to sustain a stable insurance pool,” James C. Capretta, a senior fellow at the Ethics and Public Policy Center and a visiting fellow at the American Enterprise Institute, wrote in a column published Tuesday in National Review Online.
Democrats hailed the 7 million tally. “Americans have spoken by the millions in their desire for more affordable, comprehensive health insurance,” said Rep. Sander Levin, D-Mich, the ranking member of the House Ways and Means Committee. “Insurance that can’t kick them off when they get sick. Insurance that can’t limit lifetime coverage. Insurance that doesn’t threaten to bankrupt their families when an illness strikes. The amount of interest in the insurance exchanges demonstrates that the reality experienced in health care reform refutes the Republican rhetoric to destroy it.”
House Speaker John Boehner, R-Ohio, said House Republicans would continue with their efforts to repeal the law. “The president’s health care law continues to wreak havoc on American families, small businesses and our economy, and as I’ve said many times, the problem was never just about the website – it’s the whole law,” Boehner said in a statement. “Millions of Americans are seeing their premiums rise, not the lower prices the president promised. Many small businesses are afraid to hire new workers, instead cutting hours and dropping health coverage for existing employees. Many Americans can no longer see their family doctor, despite the pledge no one would lose access to their physician.”
Capretta’s column expressed similar concerns. “The end result will be a reduction in the uninsured of some magnitude, that’s for sure,” he wrote. “But it was never going to be hard to reduce the uninsured if that was all that concerned policymakers. Massive public subsidies and expansion of free public-insurance programs can expand insurance enrollment, so long as others were willing to pay for it.”
Obama acknowledged the health law’s bumpy rollout and warned there may be more days ahead where the website isn’t working and said some parts of the law must be improved. A handful of Senate Democrats – including some facing tough re-election campaigns – have introduced legislation to change some elements of the law, including adding a less generous level of coverage that would be cheaper than those currently on the exchanges and making coverage optional for employers with up to 100 workers.
Addressing an audience that included key congressional Democrats and administration officials, Obama chided Republicans and other critics who have pushed for the law’s repeal without offering alternatives and urged them to work with him and Democrats to make changes. “Why are folks working so hard for people not to have health insurance?” Obama asked, adding later, “there are still no death panels. Armageddon has not arrived. Instead this law is helping millions of Americans and in the coming years it will help millions more.”
(Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.)