Human Services

Despite Increased Enrollment, Obamacare Still in Hot Water

In a recent Buzzfeed video that has already logged over 5.5 million views, President Obama reminded us all that the Affordable Care Act’s second open-enrollment period ends Sunday. And yet federal officials have already begun trumpeting the numbers.

Early this month, Sylvia Mathews-Burwell, secretary of the Department of Health and Human Services, estimated that 10 million people had already gained access to coverage under the law. If accurate, the secretary’s estimate would surpass the administration’s stated goal of 9.1 million new and continuing enrollees before the February 15 deadline. However, this figure still represents 4 million fewer people than what had been projected by the Congressional Budget Office in April of last year.

It remains to be seen how much of this observed increase has been due to the hiked-up fines for failure to purchase health insurance in 2015.

While last year’s penalty cap for non-compliance was a relatively modest $95 per adult (and $285 per family), or one percent of income— whichever was greater—those figures have since sharply increased. Failure to heed the ACA’s individual mandate this year will result in a hefty fine of the great of $325 per person (and $975 per family), or two percent of household income.

This penalty will be assessed on the 2016 federal income tax returns of those who decline to purchase health insurance by February 15 (and who don’t qualify for an exemption). In addition, these individuals will be barred from obtaining coverage through an exchange until the next open enrollment period beginning in October. Consumers looking to avoid this penalty will need to maintain insurance coverage for at least nine months in 2015.

Meanwhile, the administration contends that the bulk of this year’s new enrollees will be culled from the ranks of the previously-uninsured. A larger question, however, is where the majority of uninsured are finding coverage. A number of experts have noted that a significant number of Americans newly insured have been enrolled not in private insurance coverage but in Medicaid, a program described by pundits as “America’s worst health-care program.”

Yet while the enrollment figures tick up and the Medicaid pools grow larger, the debate surrounding premium subsidies rages on. Next month, the Supreme Court will hear oral arguments in King v. Burwell, a challenge to the IRS rule authorizing subsidies on federal exchanges. While some would like to see the administration notify enrollees that subsidies in some 37 states are at risk, the administration has avoided the issue. Indeed, despite probing from members of Congress, Secretary Mathews-Burwell has kept mum on whether the administration even has a contingency plan for a decision ruling subsidies illegal.

Keep this all in mind as you read the rosy headlines sure to crop up around the mediasphere next week. Enrollment figures don’t tell the whole story.


In Depth: Human Services

The welfare state is larger than it has ever been in U.S. history. As Americans we spend nearly one trillion dollars a year on federal and state human services programs, yet despite public investment the poverty rate has risen to 15.1 percent. Public assistance is necessary to help those who…

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