WASHINGTON – The number of consumers purchasing health insurance under the Affordable Care Act has surpassed five million and President Obama is becoming increasingly optimistic that enough people have signed up to assure the law’s survival.
Appearing on WebMD last week, Obama told interviewer Lisa Zamosky that the program, popularly known as Obamacare, is “stable” despite early setbacks, assuring that healthcare firms that invested in the system likely will remain on board.
“Well, at this point, enough people are signing up that the Affordable Care Act is going to work,” Obama said before the official announcement that sign-ups had passed the five million mark. “The insurance companies will continue to offer plans.”
With the March 31 deadline to obtain insurance under the law quickly approaching, Obamacare has experienced a late surge. About one million people enrolled in the program over the last two weeks alone – more than signed up during the entire month of February.
“The last several days have been the busiest since December, with the Call Center taking more than 198,000 calls on Thursday alone –the busiest day since December 23—and more than 130,000 calls over the weekend,” said Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services, the agency that oversees much of the ACA. “Last week, HealthCare.gov saw more than four million visits — and an additional one million visits this weekend.”
With two weeks to go before the sign-up deadline, “we’re continuing to work hard to ensure that every American who wants to enroll in affordable coverage… is able to do so,” Tavenner said.
Officials predicted the pace would quicken as the deadline approached, citing the experience in Massachusetts, which features its own law requiring residents to obtain health insurance. Part of the surge is attributed to Obama’s recent appearance on Between Two Ferns, an internet comedy series hosted by actor Zach Galifianakis aimed at a young audience – the same audience Obamacare is looking to attract. The show attracted approximately 19 million viewers.
“What we want is for people to know is that you can get affordable healthcare,” Obama said during the show. “Most young Americans, right now, they’re not covered and the truth is they can get coverage all for what it costs you to pay your cell phone bill.”
If enrollment maintains the current strong pace the Affordable Care Act could come close to registering six million consumers during the program’s first year – the revised number projected by the Congressional Budget Office. The administration initially targeted seven million, but a disastrous roll-out – featuring computer glitches and poor communications – led to the reduction.
Hitting the target won’t answer many of the concerns posed to officials that could confirm the vitality of the health of the program. The Obama administration has yet to reveal how many of the five million applicants have actually paid for their health insurance plans. And Obama himself, during the WedMD interview, said it has yet to be determined if the risk pool is sufficiently diverse to guard against the potential for skyrocketing premiums.
“You know, the impact in terms of the program has always been based more on the mix of people who sign up,” Obama said. “Do we have a mix of people who are gray-haired like me and may have some old basketball injuries and aches and pains, along with young people who are healthy and don’t really have any issues right now? Do we have a good mix of gender, in terms of men and women?”
And there is still a substantial amount of tinkering going on. Last week, for instance, the administration extended for a third time the Pre-Existing Condition Insurance Plan (PCIP), which was slated to expire on March 31. The program was created to aid individuals encountering financial problems purchasing insurance because of pre-existing medical conditions.
Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services, said the extension was adopted to provide those enrolled in PCIP “additional time to shop for new coverage while they receive ongoing care and treatment they need.”
The administration also has changed course on the impact sequestration – across-the-board budget cuts adopted by Congress – might have on the program. Originally the White House acknowledged that sequestration would affect a cost-sharing subsidy program that made direct payments to insurance companies on behalf of low-income individuals to offset spending on medical co-pays, deductibles and other out-of-pocket expenses.
Now the administration maintains the cost-sharing is no longer open to budget cuts – a decision that drew a sharp rebuke from Senate Republican Whip John Cornyn, of Texas.
“After all his claims that he was powerless to stop the effects of the sequester, the president is now conveniently exempting a portion of his failed healthcare law,” Cornyn said. “Rather than cherry-picking when the law applies in order to prop up Obamacare, President Obama should focus his attention on policies to grow the economy, increase jobs and address his flawed healthcare law.”
Congressional Republicans are continuing to fight the overall program. The GOP-controlled House on Friday, with a more substantial number of Democrats than normal joining in, voted 238-131 to delay the individual mandate – the Obamacare provision requiring everyone to obtain health insurance — until 2018.
The measure has no chance of making it through the Democrat-controlled Senate. The CBO concluded it would result in an estimated 13 million fewer people maintaining coverage than if the current mandate were kept in place. The Obama administration and health insurance firms both insist the mandate is necessary to prohibit consumers from waiting until they get sick to purchase coverage which would boost premium costs.
The House has voted more than 50 times to repeal the Affordable Care Act and efforts continue to kill it or render it worthless. The attempts thus far have proved fruitless, but lawmakers are still looking for ways.
Last week 25 of the Senate’s 45 Republican members, led by Sen. Lamar Alexander (R-Tenn.), sent a letter to Sylvia Mathews Burwell, director of the Office of Management and Budget, demanding that the administration rescind a rule creating “an unwarranted special carve out” for some labor unions “over other Americans” regarding Obamacare-related fees.
The administration issued a rule on March 5 exempting some self-insured health plans – such as those commonly operated by labor organizations — from reinsurance fees included in the Affordable Care Act. The three-year, $25 billion reinsurance fee is meant to stabilize the individual market in case too many sick customers obtain insurance between 2014 and 2016.
Prior to the issuance of that final rule, the fee applied equally to everyone with a private health insurance plan or a health plan administered by a private insurer.
In the letter, the 25 lawmakers characterized as “unacceptable” a carve out that would “ultimately be borne by every other American with private health insurance.”
“Obamacare is not working,” they said. “This regulation is the most recent in a long line of confusing delays, exemptions and politically motivated crony rewards. Obamacare should be repealed and replaced with step-by-step, patient-centered reforms that drive down costs and that Americans actually want.”
The lawmakers asserted that they are “willing to work with anyone who will help enact common-sense laws that could actually lower premiums and insure more people.”
The letter, like previous attempts to attack Obamacare, is unlikely to have any impact. But Republicans may stand a good chance at the ballot box in November.
Obamacare remains widely unpopular with the voting public despite the enrollment uptick. A CNN/Opinion Research Poll conducted March 7-9 revealed that 57 percent of those questioned oppose the healthcare law while only 39 percent expressed approval. Those numbers could spell disaster for Democrats in the upcoming election.
Earlier this month, Republicans retained a Florida House seat, open as the result of the death of former Rep. Bill Young, a Republican, even though the winner, Rep. David Jolly, was outspent by a higher-profile Democratic opponent in a district that Obama carried twice.
Political analyst Charlie Cook, writing in the National Journal, called the Florida result “a signal that Obama’s low poll numbers and the Affordable Care Act’s unpopularity will very likely cost Democrats seats.”
Currently, Democrats hold a 53-45 advantage over the GOP in the upper chamber, with two independents general siding with the Democrats. Republicans will need to pick up six seats to gain the majority and right now, Cook wrote, “the wind certainly appears to be blowing in favor of Republicans. The main question is whether it is a light, moderate, strong, or hurricane-force wind.”
Of the 20 Democratic seats up this year, seven are in states carried by Republican presidential candidate Mitt Romney in 2012. In six of those states Romney won by double-digit margins.
Several Democratic incumbents – Sen. Kay Hagan (D-N.C.), Sen. Mary Landrieu (D-La.), Sen. Mark Begich (D-Ark.), and Sen. Mark Pryor (D-Ark.) – are either behind, tied or slightly ahead in their re-election efforts. Republicans are favored to win a pair of seats currently held by Democrats who are retiring, Sen. Tim Johnson (D-S.D.) and Sen. Jay Rockefeller (D-W.Va.).
And two new possibilities have been added to the GOP pick-up list in recent days. Rep. Cory Gardner (R-Colo.) is mounting a challenge to Sen. Mark Udall (D-Colo.) in a state where the Affordable Care Act is very unpopular. Meanwhile, Sen. Jeanne Shaheen (D-N.H.) could face stiff opposition from former Massachusetts Sen. Scott Brown, a Republican who opposed Obamacare during his short term in office.