Checking In on the Affordable Care Act



It’s been a few weeks since registration began on the Marketplace for health insurance plans under the Affordable Care Act. So let’s check in: Since the site launched on October 1…

  • More than 20 million unique individuals have visited the federal website, healthcare.gov.
  • Almost half a million Americans have applied for health insurance under the federal exchanges.
  • Some state-based exchanges have been even more successful:
    • In New York, 150,000 people have signed up for new coverage.
    • In Washington State, 35,000 have enrolled and an additional 56,000 will be enrolled pending payment of their first premium, due in December.
    • In Oregon, the number of uninsured was reduced by 10% in just two weeks.
    • And in Kentucky, the uninsured are signing up for new coverage at a rate of a thousand per day.

Despite these successes, news coverage of the ACA has focused on one major problem: the technical performance of the website, where Americans in many states can purchase health insurance from federally-run exchanges. The problems with the site are unquestionably real, and worthy of some focus. After all, the website is one important way for Americans to obtain health insurance. But the problems with the website are no reason to despair. Why not?

1)    The website is being improved.

The Administration knows that there are problems with the site. On Monday, the President acknowledged the issues, claiming that “no one is angrier” with the website’s flaws than he is. The Department of Health and Human Services is working hard to make significant improvements to the site. On Tuesday, the Administration tapped Jeffrey Zients, formerly Acting OMB Director and Chief Performance Officer of the United States, to supervise improvements to the online enrollment process. Healthcare.gov will hopefully be on track soon!

2)    There are other ways to get the new insurance plans.

Healtchare.gov is one way to enroll in the new insurance plans available under the ACA. But until all of the gliches are improved, there are other ways to enroll.

  • Apply with a paper application
  • Apply by phone, by calling 1-800-318-2596
  • Apply with the assistance of a Navigator, Certified Application Counselor, or certain government agency officers. Learn about the options in your area here.

3)    The website is not the Affordable Care Act.

While we wait for the website to improve, it’s important to remember that the Affordable Care Act is not just a website! It’s a landmark piece of legislation that fundamentally reforms the way healthcare services are delivered. The ACA has dozens of component pieces designed to increase Americans’ ability to access quality and affordable health insurance. The website is not the product here: health insurance is the product, and it’s a good product.

4)    The law is working!

One key group of Americans is enrolling: those covered by the ACA’s Medicaid expansion. While not all states have expanded Medicaid to cover millions of poor Americans, 25 states plus D.C. have done so including Ohio, as of Monday. Additionally, three million young Americans are able to stay on their parents’ plans until 26; those with pre-existing conditions can no longer be denied insurance; preventative care funding has increased; subsidies for many Americans to purchase health insurance are now available; all insurance plans must now be more cost-effective and affordable; and, dozens of other provisions are kicking in. While the website is having serious issues, the Affordable Care Act is working.

It is no doubt true that problems with healthcare.gov are frustrating for those of us who care about fulfilling our obligation to provide healthcare to our communities. Let’s get it fixed soon. But let’s also remember that the problems with the website are masking the real feat of the ACA: providing quality and affordable health insurance to millions of Americans.

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Charlie Arnowitz

About Charlie Arnowitz

Charlie Arnowitz is a Legislative Assistant at the RAC, responsible for civil rights, immigration, and healthcare issues. He is a native of Highland Park, IL and a 2013 graduate of Vermont's Middlebury College.

2 Responses to “Checking In on the Affordable Care Act”

  1. I was looking for Nancy Pelosi’s website but was directed to the URJ; but I repeat myself.

    To concede that ‘there are problems on the site” is akin to the Titanic’s captain admitting that there may be a problem with the ship. Unfortunately for Obamacare cheerleaders, the website is only the tip of the iceberg and today’s despair will seem naively optimistic in the coming months.

    The website is a cornerstone of the ACA. That it crashed when tested with a few hundred users, now needs 5,000,000 lines of code rewritten and is sending incomplete or wrong data to insurers, suggests that it’s not a flaw; it’s a feature. While there are other ways to get the new insurance plans, the telephone application is linked to the website as even MSNBC newsreaders have documented to their chagrin.

    Moreover, the website is contributing to the ‘adverse selection’ that will make the ACA even more unaffordable. The ACA assumes that young, healthy individuals will voluntarily sign up for a product they do not need to subsidize older sicker enrollees. The only people who would tolerate spending hours and hours on the website are those who are sick and can’t afford unsubsidized insurance. A healthy millennial won’t do it. And since the IRS won’t attempt to collect the penalty for being uninsured, they have even no incentive to fight through the website to enroll. As an example, today The Buffalo News is reporting that nearly 2/3’s of the 37,000 enrollees in NY State have been directed to Medicaid. I would suggest that if our idealist young interns at the URJ are truly committed to living out their principles, they should all sign up for the overpriced insurance they supported probably don’t need and likely can’t afford and not stay on mommy and daddy’s plan until they are 26. By the way, 26 year olds used to be called ‘adults’ and not ‘young Americans’.

    To date significantly more people have had their current insurance plan cancelled than have enrolled in the ACA; belying the oft repeated claim that “if you like your current plan you can keep it”. For those able to keep their current plans, prices have gone up, often substantially. What happened to the promise of $2,500 annual savings per family? One more bit of good news, the most recent CBO analysis projects that the ACA will cost $1.8 trillion over the first 10 years; double the President’s initial promise. For that bargain price, the Journal of Health Affairs notes that we will still have 30 million uninsured. If this is the URJ’s definition of ‘working’, I’d love to see what broken looks like. Unfortunately, I suspect we soon will….

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