While the full effects of the Patient Protection and Affordable Care Act won't be known for years, the recently passed deadline for individuals to obtain health insurance or pay a tax penalty makes this a good time to assess its progress to date.
Despite a disastrous rollout, with malfunctioning websites, and active resistance from governors in many red states, the enrollment numbers are quite promising.
Prior to the March 31 deadline, 7.1 million people signed up for individual coverage using the state and federal health care exchanges, slightly exceeding initial Obama administration projections. The figure will keep growing as insurers process applications delayed by balky websites.
And that's just part of the tally.
The 2010 law also funded an expansion of health insurance programs for the poor, which about half the states have adopted, and it matched the individual mandate with a requirement that businesses with more than 50 full-time employees offer health insurance.
The employer mandate is on hold until next year, but new Rand Corp. survey data shows gains in employment-based insurance outpacing enrollment through the state and federal exchanges.
Combining the growth in job-based coverage, Medicaid expansion and the exchanges, Rand found a net increase of 9.3 million adults with health coverage between mid-September and mid-March.
That translates to a 25 percent reduction in the number of uninsured Americans — and the survey was completed before the last-minute rush to beat the deadline. Again, it's safe to expect that an even better result when enrollment data catches up.
Among the survey's details:
- About 14.5 million people gained coverage, and 5.2 million lost coverage, for a net increase of 9.3 million.
- The biggest gains and losses were in the category of employer-based coverage.
- Fewer than a million people who went from insured to uninsured previously had individual policies. However, the survey didn't distinguish between those who gave up their insurance due to cost or other reasons and those whose policies were canceled because they didn't meet the minimum standards established by the Affordable Care Act.
- Those without health insurance declined from 20.5 percent to 15.8 percent of the population.
A nightmare? It isn't easy to reconcile those numbers with Senate Republican leader Mitch McConnell's assessment, delivered just a week ago.
But Obamacare, as it's commonly known, isn't an unbridled success. Ask Kathleen Sebelius. The ex-Health and Human Services secretary who was blamed for the rocky rollout is out of a job.
Neither is health care reform a finished product. Reducing the ranks of the uninsured is only half of the job. The rising cost of health care has yet to be addressed in any serious way, with the Obama administration struggling with technological blunders and the House GOP staging one made-for-electioneering repeal vote after another without expectation of actually succeeding.
Call us hopeless optimists, but we think the release last week of a database showing billions of dollars in Medicare payments going to a relative handful of physicians might spur action on a languishing, bipartisan plan to begin transitioning away from fee-for-service medicine. In terms of cost control, that would be real progress to report.
©2014 The Press Democrat (Santa Rosa, Calif.)