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After a horror start, Obamacare finally gains some traction

21 Jan 2014

A relieved Obama Administration claims more than two million people have signed up for insurance cover under its controversial health reforms following a surge of enrolments in December.

As President Barack Obama seeks to undo the significant political damage caused by the disastrous launch of the Federal Government’s bug-riddled Health Insurance Marketplace website ( in October and November, White House officials claimed early this month that more than 2.1 million had enrolled in the system by the end of December.

Combined with about 4 million who have gained health coverage through the expansion of the Medicaid program (a key element of the Obamacare reform) or have for the first time been included in their parents’ health insurance under the Children’s Health Insurance Program, the Administration claims that an extra 6 million Americans have so far gained health insurance coverage as a result of its health reform.

But the accuracy of the claim has been attacked as Republican politicians and other critics of the Federal Government continue to exploit widespread unease and confusion about Obamacare in the American electorate.

Republicans have claimed that millions of people have had their existing health insurance policies cancelled as a result of the Affordable Care Act, seeking to imply that they have been left without coverage.

But a Washington Post analysis casts doubt on these claims, finding that most of the 4.7 million people who received a notice from their insurer notifying them that their old plan was cancelled, were at the same time informed that their coverage had been transferred to a new plan that was consistent with the basic requirements for health insurance inclusions as stipulated under the Act.

But the Obama Administration’s claims have also come under scrutiny, particularly its definition of enrolment.

The Washington Post warned that White House figures included people who had chosen to enrol in an insurance plan, who but who may not have yet paid their premium.

While much of the political debate has so far centred on the raw enrolment numbers, perhaps more critical to the success of the Obamacare is the demographic breadth of insurance coverage – health funds need to enrol a substantial proportion of younger, healthier members to help offset the claims made by older, sicker members.

In a promising sign for the system, at least in one state, Kentucky earlier this month that 40 per cent of the 116,000 people who had enrolled in Medicaid or qualified health plans through the state’s health insurance marketplace were younger than 35 years. According to the Washington Post, Government officials are looking for at least 30 per cent of enrolees to be younger than 35 years to make the reform sustainable.

After its very shaky start, White House officials are keen to get the system operating and generate positive media coverage.

In a statement issued on New Year’s Day, the Secretary of Health and Human Services Kathleen Sebelius said the Government would work hard to ensure that “every American who wants to enrol in Marketplace coverage by the end of the open enrolment period on March 31, 2014, is able to do so - and enjoy the security and peace of mind that comes with having quality health coverage”.

But the long-term viability of the reform remains uncertain.

As the Washington Post warned, “it’s important to remember that the health care marketplace is not a single entity, but at least 51 different marketplaces, each with its own risk pool, so it is quite possible some states will do very well while others might end up with an unbalanced mix”.

Adrian Rollins

Published: 21 Jan 2014