White House Moves Obamacare Goalposts Again

Another day, another self-imposed standard gets watered down.

President Barack Obama speaks at Temple Emanu-El November 6, 2013 in Dallas, Texas.
National Journal
Sam Baker
Add to Briefcase
Sam Baker
Jan. 14, 2014, 5:10 p.m.

The White House is scal­ing back an­oth­er self-im­posed stand­ard for Obama­care’s suc­cess — and it’s one the ad­min­is­tra­tion has spent months pro­mot­ing.

White House of­fi­cials con­sist­ently — and ac­cur­ately — ar­gue that the most im­port­ant met­ric for Obama­care’s suc­cess this year is the mix of young and old en­rollees. But they’re back­ing away from their own goals for that mix.

Get­ting young people in­to the sys­tem is crit­ic­al to hold­ing down premi­ums, and there­fore to keep­ing each state’s in­sur­ance mar­ket stable. Ad­min­is­tra­tion of­fi­cials pre­vi­ously said their tar­get was for young adults to make up about 38 per­cent of Obama­care en­rollees. Now that stand­ard is down to about 30 per­cent. Or maybe even 24 per­cent — where the mix stands now.

It was the White House that set the ini­tial tar­get of 38 per­cent en­roll­ment for young adults. But of­fi­cials wouldn’t stand by that fig­ure this week.

The Health and Hu­man Ser­vices De­part­ment re­leased its first age break­down on Monday, show­ing that about 24 per­cent of Obama­care en­rollees are between 18 and 34. Of­fi­cials from HHS and the White House her­al­ded the fig­ure as a suc­cess be­cause it makes an in­sur­ance “death spir­al” — Obama­care’s worst-case scen­ario — ap­pear all but im­possible.

The ad­min­is­tra­tion may well hit its ini­tial 38 per­cent tar­get, but it’s ap­par­ently abandon­ing that goal pree­mpt­ively, de­clar­ing suc­cess just by avoid­ing the worst pos­sible out­come.

“We are already at that stage of pre­lim­in­ary sus­tain­ab­il­ity with three months left to go,” an ad­min­is­tra­tion of­fi­cial said.

The thing is, that’s prob­ably true. Young-adult en­roll­ment looks OK. It was nev­er ex­pec­ted to hit its fi­nal tar­get at this stage; young people will likely sign up at the last minute, and the fi­nal dead­line to en­roll isn’t un­til March.

Pro­jec­tions from the Kais­er Fam­ily Found­a­tion show that the health care law’s new in­sur­ance mar­kets could be vi­able with young-adult en­roll­ment as low as 25 per­cent — the bar the White House has already cleared. When Mas­sachu­setts im­ple­men­ted the first draft of Obama­care in 2006, its mar­ket­place proved sus­tain­able with 30 per­cent en­roll­ment among young adults.

But, once again, ad­min­is­tra­tion of­fi­cials are lower­ing their own stand­ards for suc­cess — ditch­ing tar­gets they set or em­braced, and re­de­fin­ing suc­cess as any­thing that’s good enough to avoid a total col­lapse. It was the White House that set the ini­tial tar­get of 38 per­cent en­roll­ment for young adults. But of­fi­cials wouldn’t stand by that fig­ure this week.

“There’s a dif­fer­ence between that num­ber and what’s re­quired for a sus­tain­able mar­ket,” the seni­or ad­min­is­tra­tion of­fi­cial said.

The White House has already dis­avowed its self-iden­ti­fied “tar­get” for over­all en­roll­ment: 7 mil­lion people in the first year. In down­play­ing that num­ber, the White House and HHS have ar­gued that the age mix is more im­port­ant than over­all en­roll­ment — which it is, from a policy per­spect­ive.

But just as of­fi­cials haven’t re­leased a new tar­get for over­all en­roll­ment, they’re also lower­ing ex­pect­a­tions for the mix of old and young en­rollees. The White House said Monday that it had cleared the first bar — a good enough mix for a sus­tain­able mar­ket. Is there an­oth­er goal, more am­bi­tious than avoid­ing dis­aster?

“From now on, the ul­ti­mate goal is to get as many people in­sured as pos­sible,” the ad­min­is­tra­tion of­fi­cial told re­port­ers.

HHS of­fi­cials also would not com­mit to the ad­min­is­tra­tion’s earli­er goals for young-adult en­roll­ment. The num­ber had been “over­blown” as a make-or-break fig­ure, one HHS of­fi­cial said.

A mix that’s good enough to avoid a “death spir­al” could still af­fect in­sur­ance premi­ums next year. The sick­er the over­all mar­ket­place is, the more premi­ums are likely to rise.

(In this con­text, “young people” are a proxy for “healthy people.” Health status is what af­fects premi­ums, not age. But be­cause in­surers are no longer al­lowed to vary their premi­ums based on preex­ist­ing con­di­tions, the ap­plic­a­tion for cov­er­age doesn’t ask about health prob­lems. Young people are pre­sumed to be health­i­er on av­er­age, and that’s why they’re so highly coveted.)

A mix of roughly 25 per­cent young adults would cause in­surers to raise their premi­ums, Kais­er pre­dicted, but not enough to cause a “death spir­al.” Kais­er said the new in­sur­ance mar­ket­places would re­main vi­able even in that “worst-case scen­ario,” al­though premi­ums would be less likely to rise with more young people in the mix.

In­surers are already con­cerned, however, that this year’s en­roll­ment pool might not be as healthy as they pro­jec­ted. The tech­nic­al prob­lems with Health­Care.gov de­pressed over­all en­roll­ment, and ex­ec­ut­ives from Hu­mana have also said Pres­id­ent Obama’s de­cision to help un-can­cel cer­tain in­sur­ance policies has also kept healthy people out of the mar­ket.

What We're Following See More »
SANS PROOF
NRA Chief: Leftist Protesters Are Paid
21 hours ago
UPDATE
NEW TRAVEL BAN COMING SOON
Trump Still on Campaign Rhetoric
23 hours ago
UPDATE
“WE’RE CHANGING IT”
Trump Rails On Obamacare
1 days ago
UPDATE

After spending a few minutes re-litigating the Democratic primary, Donald Trump turned his focus to Obamacare. “I inherited a mess, believe me. We also inherited a failed healthcare law that threatens our medical system with absolute and total catastrophe” he said. “I’ve been watching and nobody says it, but Obamacare doesn’t work.” He finished, "so we're going to repeal and replace Obamacare."

FAKE NEWS
Trump Goes After The Media
1 days ago
UPDATE

Donald Trump lobbed his first attack at the “dishonest media” about a minute into his speech, saying that the media would not appropriately cover the standing ovation that he received. “We are fighting the fake news,” he said, before doubling down on his previous claim that the press is “the enemy of the people." However, he made a distinction, saying that he doesn't think all media is the enemy, just the "fake news."

FBI TURNED DOWN REQUEST
Report: Trump Asked FBI to Deny Russia Stories
1 days ago
THE LATEST

"The FBI rejected a recent White House request to publicly knock down media reports about communications between Donald Trump's associates and Russians known to US intelligence during the 2016 presidential campaign, multiple US officials briefed on the matter tell CNN. But a White House official said late Thursday that the request was only made after the FBI indicated to the White House it did not believe the reporting to be accurate."

Source:
×
×

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.

Login