October 21, 2013

TRAIN WRECK UPDATE: The ACA’s Million Dollar Question: Will Enough People Sign Up?

More and more health care watchers are questioning whether enough young adults will sign up for insurance under the ACA to keep the system afloat. The latest is centrist think tank The Brookings Institute, which has a new report out on Obamacare entitled “The Affordable Care Act: A User’s Guide to Implementation.” The report argues, among other things, that there’s a possible flaw built into the law that could undermine the whole system. The penalty for not buying insurance could be too low to convince young healthy individuals to sign up for insurance, thus creating adverse selection.

Here’s the question: If ObamaCare needs twentysomethings to sign up in order to be a success, why did Obama support letting them stay on their parents’ insurance?


We’ve known that adverse selection and enrollment failure could be a problem with the law for some time now, but the fact that the Brookings Institute is flagging it suggests that centrists are also feeling uncertain these days about the law’s ability to succeed. Indeed, the Brookings Report is part of a flood of appalled center and center left commentary about flaws in the ACA.

Now that the government shutdown is over, the MSM is beginning to increase its coverage of what, so far, looks like a systemic failure of the ACA in its early rollout. Negative coverage — of how hard it is to enroll, how badly the program as a whole is working, how unpopular it remains — will likely make all but the most motivated customers stay away. Those customers will be exactly the ones Obamacare does not need: customers with expensive pre-existing conditions whose need for insurance is so dire that they will fight through any and all obstacles to get enrolled.

All told, we wonder if Nancy Pelosi, Harry Reid and President Obama are as happy today about Obamacare as they were on the day the law was passed. Beyond that, everything that has happened since passage has confirmed our view that far from solving the problems facing American health care, this poorly drafted, poorly executed system makes the problem of health care reform both more urgent and more difficult.

Ya think?

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