One of the remarkable aspects of the politics of health reform is the way conservatives — even relatively mild, seemingly informed conservatives — have managed to keep believing that Obamacare is unraveling, despite the repeated failure of disaster predictions to come true. Part of the way this works is that captive media and the right’s pet “experts” hype every bit of bad news, but go silent when the news is good (and, often, when the bad news turns out to have been a false alarm.) How many will even hear about the news that enrollments are once again running above expectations, and the pool is getting younger?
Anyway, it’s really helpful to have this new report from the Commonwealth Fund comparing actual performance with pre-implementation predictions. Premiums came in far below expectations; part, but only part, of this positive surprise was given back by 2016 premium hikes, with overall costs still looking very good.
On enrollments: fewer people than expected signed up for the exchanges, but an important reason was that fewer employers than expected ended coverage and moved their employees into the individual market. Meanwhile, Medicaid expanded more than expected — and the overall reduction in the number of uninsured was pretty much in line with forecasts:
So the program is achieving its goals, albeit with a somewhat different mix of kinds of insurance than predicted, and doing so more cheaply than expected. That’s a big success story — and remember, the critics scoffed at those expectations and predicted utter disaster.
Paul Krugman, New York Times Dec 23, 2015