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Wednesday, January 01, 2014

Wait Just a Minute: the Affordable Care Act May Work

The withering criticism of the Affordable Care Act ("Obamacare") has led many to believe that it is a disaster, that it will never work, etc...  If you only watch conservative television or listen to conservative talk radio and politicians then you might be convinced of this "fact".  Best to hang on for a moment.

One of the criticisms is that "nobody is signing up" as often-reported on Fox News which is omnipresent in the YMCA where I work out.  Early in the enrollment process there were daily reports of "single digit" enrollments in some states.  This was due to the HHS software being as bad at reporting as it was at enrolling.

The software bugs are being fixed and enrollments are happening, and this week no more conservative voice than The Washington Post reports that HHS may actually meet their first enrollment goal of 7 million enrollees for 2014.  If that target is attained, given the large amount of negative publicity, the daily rants from conservative media, the software debacle and a Republican campaign last fall to discourage enrollment by uninsured Americans, it will be a significant accomplishment.

Personally I have seen two anecdotal situations that affirm this forward momentum.  I have a family member who was unable to afford coverage for himself and his wife because of her preexisting conditions.  Last month they secured subsidized coverage for the two of them for $120/month.  The first month of Exchange enrollment I had a friend, a small-market realtor, who looked on line and complained to me that single coverage for her would be over $600/month.  After working through the repaired website and getting to the subsidy calculations, she secured free coverage for a bronze plan.

Time will tell what full implementation of the ACA brings.  Right now it is still a political football with supporters looking past every flaw and detractors ignoring every success.  Looking at it impartially (although I am on record as supporting universal, non-employer-sponsored coverage) the program has a fighting chance to overcome Kathleen Sebelius' incompetence and the Republican opposition machine.  It will certainly have unintended consequences: all changes of this magnitude do. The ultimate question will be 2-3 years down the road when we attain full implementation, see the consequences both intended and unintended, and judge for ourselves if this was or was not a societal step forward.

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