Health Care
April 17, 2014
Can Obama’s health-insurance expansion recover from its shaky rollout?

Despite a rocky start and Republicans’ continued efforts to repeal, defund or delay the Affordable Care Act, President Obama’s landmark health insurance law has triggered the nation’s largest expansion in health insurance coverage in 50 years. By the time the law’s March 31 sign-up deadline had passed, between 7.1 million and 9.5 million people had bought insurance under the program. It is unknown whether the law will eventually reduce medical costs, as supporters claim, and the act continues to face legal, political and ideological challenges. The GOP says the law imposes federal control over private medical decisions, and conservative religious employers have challenged the law — all the way to the Supreme Court — over its mandate that they cover employees’ contraceptives. Republican congressional candidates say they plan to use the law’s unpopularity among many GOP voters to rally strong turnout to defeat Democrats in the mid-term elections next fall.

Insurance broker Lindsay Adams (back to camera) helps the Shiferaw family figure out their options. (Getty Images/The Denver Post/Kathryn Scott Osler) With the March 31 deadline for signing up for health insurance under the Affordable Care Act approaching, insurance broker Lindsay Adams (back to camera) helps the Shiferaw family figure out their options at an enrollment site in a downtown Denver mall on March 24. By the time the deadline passed, more than 7 million people had signed up for the program. (Getty Images/The Denver Post/Kathryn Scott Osler)

After the March 31 deadline passed for signing up for health insurance under the Patient Protection and Affordable Care Act (ACA), the White House announced that more than 7 million people had bought coverage under the landmark program, dubbed Obamacare. But some health-care analysts calculated that the number was as high as 9.5 million when those who signed up through state insurance exchanges, private insurers and expanded Medicaid coverage were counted. 1 That’s considerably more than ACA supporters feared in late 2013 would be the total, when technical glitches slowed enrollment on the federal exchange to a crawl. Moreover, the share of enrollees in the 18-34 age bracket, the healthiest group of insurance consumers, had ticked up to 27 percent by February and continued strong in March. (Enrollment of healthy people is necessary to spread costs in an insurance pool.) Obama and many insurance analysts say there are likely enough younger participants in the ACA program to keep premiums from soaring out of sight. 2

“At this point, enough people are signing up that the Affordable Care Act is going to work,” Obama said in mid-March. “The pool is already large enough.… I’m confident the program will be stable.” 3