First, the Obamacare Truthers—the Republicans and conservatives who insist that every piece of remotely positive news about the health-care law’s impact has to be a filthy lie—lost the battle of the enrollment figures. The issue here isn’t whether the Obama administration is telling the complete truth when it says 8 million. The issue is that the Truthers predicted 3 million, 2 million, 1 million, 0 million, a death spiral. And whether the administration is gilding the lily and the real number is 8 or 7.7 or 7.4 million, the hard fact is the Truthers were just crazy wrong.
Having lost that battle, they’ve now opened fire on a second front. Maybe the enrollment numbers are wrong, maybe they’re right, the Truthers say, but that doesn’t matter. What matters is the percentage of people who actually pay their premiums.
There is some truth (as opposed to Truth) to this. People can sign up with every intention of paying and then get hit with something—an unexpected car-repair bill—and they can’t pay. Or more likely, they’re young and healthy, and they decide “What was I thinking, I got all caught up in Zach Galifianakis fever?”—and they don’t pay. And if the young and healthy (who cost the insurance companies nothing) don’t pay, then the only people in the system are the old and sick, who cost the insurance companies a lot, and premiums skyrocket.
So in some ways the “percentage paying” number is even more important than the raw enrollment number. It is, after all, the real enrollment number, the number of people actually getting and keeping health coverage. And so the second the Truthers lost the enrollment fight, they moved to the percentage battle. This will prove that Obamacare can’t work.
On Wednesday, the House Energy and Commerce Committee put out a report looking at enrollment (“report” is overdoing it; it’s one page). It was methodologically pretty simple. They collected data from every insurer participating in what’s called the Federally Facilitated Marketplace (FFM) and looked at who’d signed up for coverage and who’d paid a first premium by April 15. The House panel’s answer was 67 percent.
Now, 67 percent doesn’t sound half bad to me, but the GOP spun it as yet another Obamacare disaster—it would push the “real enrollment” number down near 5 million and mean that one in three people who’d signed up for health-care coverage was already delinquent. They didn’t quite say that, but it was obviously the whole point of the report. “Tired of receiving incomplete pictures of enrollment in the health-care law, we went right to the source and found that the administration’s recent declarations of success may be unfounded,” said committee chairman Fred Upton of Michigan.
The committee got what it wanted: Headlines saying only 67 percent of ACA enrollees were paying. I’m sure there was ample coverage on Fox News, and it blasted out across the talk-radio waves. They have a talking point now, and a number, and it’s low enough that they can spin it as a lousy number.
The only problem is, it’s a wrong number.
The Democratic minority on the committee released a memorandum slicing the majority’s logic to pieces in a matter of three paragraphs. Actually, it can be done in one sentence: Lots of enrollees’ first premiums weren’t even due by April 15!
Here’s a little language from the Democratic memo that lays it out a bit more fully: “As of April 15, premiums had only come due for individuals who had signed up for coverage before March 15. Five million individuals had enrolled in coverage through the marketplaces as of March 17. On April 17, the president announced that 8 million Americans had signed up for coverage through the marketplaces. That means that more than 3 million enrollees—or nearly 40 percent of all enrollees—did not have premiums due by April 15 and therefore were not required to have paid them by that point.”
In other words, people who didn’t even have premiums due yet, and who account for 37.5 percent of all enrollees, are counted in this GOP report as part of the delinquent third.
If you don’t want to take it from Democrats, take it from the insurance officials themselves. They dispute the GOP numbers. Karen Ignani of AHIP, a large group of providers, said the pay-up rate so far in her realm has been 85 percent. The Blue Cross-Blue Shield group says 80 to 85 percent of enrollees have been paying. And WellPoint announced, on the very day of the GOP report, that its figure was 90 percent.
In addition, Talking Points Memo’s Dylan Scott got hold of the questionnaire the committee sent to insurers, and it’s a joke. One industry source—not a Democratic operative—told Scott: “Everyone who saw it knew exactly what the goal was.”
I asked the GOP staff at the committee if they had a counter to the argument that their numbers were incomplete and in essence rigged. On background, one staffer there basically told me that they didn’t have a counter. The committee press release makes it clear, I was told, that these data represent payments only through April 15, and the committee will seek another report May 20.
In other words, this staffer is saying: Yep. Which makes it rather hard to avoid the conclusion that the committee knowingly put out a bad number. Why would a committee of the House of Representatives do something like that? Well, what am I saying? We know why.
The continuing truth about Obamacare is that it’s going pretty darn well so far. The other truth is that the Obamacare Truthers will forever be among us, saying, ah, but it’s the next step that’s crucial, and that’s where the death spiral will begin! That’s our Republican Party: Hoping that millions and millions of people don’t get health coverage, just to deny the president a political win. They don’t care how many people die, as long as they take Obamacare with them.