Anytime we see something that challenges our worldview, it’s important to acknowledge it, and investigate whether our model of the world is incorrect, or at least to acknowledge our mistake. Otherwise, we cease to be engaging in discussion and building on knowledge. About a year ago, Josh, one of the former authors on this blog, wrote an excellent piece about how his predictions of massive failure for Obamacare did not seem to be coming true:
But now, a year further along, it seems the healthcare system isn’t doing so hot. The Wall Street Journal wrote in October:
Among this population of the uninsured, HHS reports that half are between the ages of 18 and 34 and nearly two-thirds are in excellent or very good health. The exchanges won’t survive actuarially unless they attract this prime demographic: ObamaCare’s individual mandate penalty and social-justice redistribution are supposed to force these low-cost consumers to buy overpriced policies to cross-subsidize everybody else. No wonder HHS Secretary Sylvia Mathews Burwell said meeting even the downgraded target is “probably pretty challenging.”
Late in December, Reason reported:
United announced during an investor briefing Thursday that it was expecting a whopping $425 million hit on its earnings this year, primarily due to mounting losses on its Obamacare exchange business. “We cannot sustain these losses,” United CEO Stephen Hensley declared.
And also in January:
Aetna, for example, has already dropped out of the exchange market in two states. A dozen of the 23 non-profit co-op plans backed by the law have already closed up shop, causing about 600,000 people to lose health plans, and a Politico analysis indicates that most of the remaining co-op plans are in trouble. Blue Cross Blue Shield of Texas and North Carolina both lost a sizable chunk of money on its exchange business during the program’s first year. The financial outlook for a number of insurers participating in Obamacare, in other words, doesn’t look good. And there are few signs that it is set to improve in the near future.
Yet, the mandates aren’t working as planned. My colleague Brian Blase recently summed up the difference between the projected numbers of people who were expected to enroll in the ACA during this third open enrollment and the people who actually did. He notes a high estimate of 12.7 million people signing up for an exchange plan. But Blase actually thinks there will only be an average of 11 million enrollees this year. That’s 16 million fewer than the Rand Corporation predicted, 11.8 million fewer than the Centers for Medicare and Medicaid Services predicted, 12.1 million fewer than the Urban Institute predicted and 10 million fewer than the Congressional Budget Office projected.
It seems more likely than not that there will need to be some sort of change to the health system. Perhaps Josh’s predictions were too dire, but overall, I would retitle his post “I was still mostly right about Obamacare”.