Big news this afternoon on the Affordable Care Act: The ACA exchange signups have reached the 6 million mark. With a few more days to go before the open sign-up period closes (well, sort of) it looks like the original 7 million estimate -- which the Congressional Budget Office had revised downward after the botched October roll-out of the federal exchange -- is going to be pretty close to the mark.
There’s nothing at all magical about this number. Reaching it doesn’t mean that Obamacare “works.” Surpassing the goal might have some effect on the federal budget (more signups, for example, presumably mean higher subsidy costs), but there’s no obvious correlation between the signup total and anything else.
There is still way more that we don’t know about this new world and the details matter a lot for insurers setting next year’s premiums. We don’t know, for example, how many of those who signed up will wind up paying premiums. We don’t know the mix of young and old. And until people start making claims, we also won't know the mix of healthy and unhealthy.
Nor do we know how many people overall are newly insured; how many are replacing canceled plans they were perfectly happy with; and how many were insured, but are finding better deals through the exchanges.
One more thing: At best, a slew of healthy signups might show that the law can function as (more or less) expected. That can’t prove whether it’s good or desirable policy.
I agree with Paul Krugman: expect a good deal of “unskewing” from conservatives who've been absolutely convinced for months that Obamacare was already a failure. As I tweeted yesterday, the busiest people this week are Republican operatives rationalizing why higher than expected enrollment is proof of failure. At any rate, healthy enrollment numbers should kill the preposterous Republican notion that people just don’t want health insurance.
"Success” and “failure” remain the wrong ways to think about Obamacare. Complete failure was always unlikely, and not even the most optimistic supporters thought the law would fix everything wrong with health care in the U.S. In the real world, what counts is how well the law performs, what its strengths and weaknesses prove to be, and what fixes would actually improve things.
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