The ‘train-wreck’ that signed up 9.5 million

Ethan: Now that Obamacare exceeded its goal of 7 million signups by April 1, are you ready to concede a small modicum of success to this program and stop calling it a “train wreck”?

Phil: Forcing people to buy a product and having it declared constitutional because it was interpreted as a tax, something the president said it was not, is not what I consider an achievement worth celebrating.

Ethan: “Having it declared constitutional.” Wow, you really do think Obama is powerful. No matter how you spin it, what we know now is that the need is strong and the product worthy, or people wouldn’t have swamped the website, phones and walk-in centers. They easily could have chosen the $95 penalty. But they didn’t. They chose Obamacare.

Phil: Again, I will refute your choice of the word “choose” because it’s the law that they have to sign up! But more importantly, there are still many hurdles to accomplish before we start declaring anything a success. First of all, how many have actually paid their first and ongoing premiums?

Ethan: I always love how you conservatives seem more concerned with how many have paid and less concerned with how many have insurance. But, to answer your question, insurance companies are saying that 80-85 percent are paying. Right in line with what they see outside the exchange.

Phil: And how many of those now with insurance didn’t have it before? Or, have we made liberals feel good by forcing people to swap one plan for the next and then claim success?

Ethan: Remember that the uninsured are getting covered through the Medicaid expansion, which is now covering at least 4.5 million new people on top of the millions more who went through the exchange. Estimates are that at least 9.5 million previously uninsured people now have coverage. Three million are getting coverage by staying on their parents’ plan.

Phil: Allowing people to stay on their parent’s plan to age 26 was one of the areas of bipartisan agreement. The political reality is that Obamacare has caused the previously insured to lose, change their plan or pay more in premiums so they can subsidize the uninsured.

Ethan: Regardless, there is a good chance that many of these young adults would not have had insurance otherwise.

Phil: The ultimate issue is whether we are actually able to control costs and bring down premiums for consumers. So far, that record is sketchy at best.

Ethan: I would say “mixed,” not sketchy. Many states have seen drops, as have certain demographics like those in middle age or older. But some in rural areas have seen increases. But I agree with you that the jury is still out on this piece. Remember, a basic premise of the expansion is that once you get more people covered, especially with preventive coverage, you reduce costs down the road. That journey has only just begun.

Phil: I must have missed President Obama’s press conference when he retracted his promise that premiums would come down $2,500.

Ethan: First of all, he didn’t promise that this legislation would drop premiums $2,500 for everyone. He said it could drop as much as $2,500, and for many families it has. Second, you have the patience of a hornet. Give the plan a chance to be fully implemented; then you’ll start to see even more savings in even more families.

Phil: Uh oh, I sense the predictable juxtaposition beginning to unfold. The one where people actually think they will see their current expenses come down when Democrats really mean the rate of increase will decrease.

Ethan: Nope, premiums have actually decreased for millions. But even if we simply slowed the rate of growth, that would be a huge advancement, wouldn’t it?

Phil: It would, but that isn’t what you sold to America when you passed the law.

Ethan: Well, we’ve got a long way to go. Millions more remain uninsured. And while you seem unable to even acknowledge a huge success like the enrollment numbers announced this week, you do need to accept the reality that Obamacare is here to stay. What will you Republicans do now?

Phil: Strive for a competitive market, so we can shop for services where price and quality meet our expectations. Adopt fairness in the tax code, so people who buy their own coverage can have the same tax exemption as people who receive health insurance through work. Implement incentives for people to weigh less, drink less and exercise more. Let consumers know what things cost, and reward them for making good choices.

Ethan: Although the tax exemption would blow a huge hole in the deficit, I can work with all that. But in return, do you think I can at least get you to consider it a good thing that at least 9.5 million have signed up for coverage they never would have had?

Phil: If you want me to be impressed that millions have loaded onto a government mandated and managed plan, then yes.

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