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Saturday, March 15, 2014

The Young Abandon Obamacare

Dana Milbank of the Washington Post wrote a lament for that paper whining about the loss of support for Obamacare of the youth of America.  Here is the heart of his column:

The administration announced last week that only 1.08 million people ages 18 to 34 had signed up for Obamacare by the end of February, or about 25 percent of total enrollees. If the proportion doesn’t improve significantly, the result likely will be fatal for the Affordable Care Act.
The administration had said it needed 40 percent of registrants in the health insurance exchanges to be young adults, or about 2.7 million of the expected 7 million total. Overall enrollment is also below target. But the alarming shortcoming is the number of young participants, which would make the insured population older and sicker and the program too expensive.

The truth is that Milbank actually makes the numbers look better for the president than the true reality.  Many of the 1.08 million people ages 18 to 34 who signed up for Obamacare are among the large percentage who have not actually bought policies.  They selected policies on line, but then they failed to complete the purchase and pay the premium.  The best estimates put the number of young people who have actually bought insurance at between roughly 500 and 600 thousand compared to the 2.7 million who were needed for the system to work.  That means that with only two weeks left in the six month sign up period, only about 20% of the necessary young people have signed up.  Even worse, many of these young people already had insurance before Obamacare came on line.  For the system to work, the government needed 2.7 million NEW young people to sign up.  It does not help fund the insurance pool if a person who already had insurance just buys another policy.  Uninsured folks had to sign up and add their premiums to the pool.  The reality is that we do not have clear numbers of just how many new young people bought insurance, but estimates put the figure as something like less than ten percent of the 2.7 million goal.  This is not just bad; it is a total disaster.

In his column, Milbank says that the reason why young people did not sign up is that Obamacare did not go far enough.  He offers no proof for that assertion, however.  The truth is that we do not know exactly why Obamacare failed so completely.  It certainly has a bit to do with all of the items listed below, but no one yet knows the extent to which each one had impact.  All we know is that president Obama's signature accomplishment was given a major Bronx cheer by one of his most important support groups.  Here are just a few of the reasons why:

1.  The Obamacare exchanges were handled in a totally incompetent manner.  Young people are used to going online and using websites or apps that work.  A "glitch" might be forgiven if it just lasts a hour or two.  Instead, they got a website that still does not fulfill all its required functions.  It is a marker of exteme failure.

2.  No one ever explained the rules clearly to the American people.  Buying health insurance is extremely complicated and the way that the plans were presented on the exchange was less than clear.  A great many people decided that the whole thing was just too complicated.  They left and they never came back.

3.  The horror stories of long waits, high premiums, high deductibles, and limited networks of doctors and hospitals made the product look shoddy and uninviting.  (Of course, that is principally because the product is shoddy and uninviting, but that is another issue.)  No one got points with their friends for actually buying insurance.

4.  Great numbers of young people still do not have and cannot find jobs.  Others are struggling in low paying jobs that make it difficult for them to make ends meet.  The media spread the word that the penalty for not buying insurance is a fine of $95 per year.  That is just not true, but the misinformation put out by the media was never corrected by the government.  As a result, huge numbers of people decided to pay $95 instead of buying insurance.  It won't be until they file their tax returns for 2014 in the Spring of 2015 that they will find out that the penalty is actually substantially higher.

5.  Now, in order to try to make up for all the lies used to sell Obamacare in the first place, the president has gutted the individual mandate.  Any impetus to buy insurance has been removed for another year.

The net effect of these and other problems is that there has been a big increase in old and sick people with insurance.  By next Fall, that new population is going to cause a major increase in the premiums for 2015.  Those who think that it was difficult getting people to buy insurance this year will see how much harder it will become next year as premiums go through the roof.



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