Enrollment through the ObamaCare exchanges has been more sluggish than initially expected, with just about 12 million sign-ups likely this year. That’s better than the 10 million or so officials projected back in October, but far less than the 21 million the Congressional Budget Office estimated as the law was taking shape.
Part of the problem seems to be that people are finding ways to game the system by signing up outside of the limited annual enrollment period and then dropping insurance shortly after. The law has a number of exemptions that allow people to buy coverage at any time throughout the year, such as changing or losing a job, having a child, moving, and getting married.
The people who come in via those special enrollment exemptions, it turns out, are far more expensive to cover. In an earnings call last November, an executive with UnitedHealth, the nation’s largest insurer, said that people buying in outside of the standard enrollment period cost about 20% more.
In the wake of Louisiana governor John Bel Edwards’ announcement last week that his state would expand Medicaid under ObamaCare, the White House rolled out a new scheme to persuade the 19 states that are still holding out to fall into line and expand their programs: throw more money at them.
But these state officials should resist the temptation, for at least three reasons:
- First and most obvious is that expansion states have all experienced the same thing: More people signed up than expected, and it blew a hole in the states’ budgets.
- The second reason is that there’s no such thing as “free” federal dollars. The money comes with conditions, which effectively shifts policymaking from the receiving state’s legislature and governor to a distant federal bureaucracy (in this case, the Centers for Medicare & Medicaid Services), which dictates how states must spend federal Medicaid funds.
- The third reason is less abstract: Medicaid will harm those it’s meant to help. Often lost in the expansion debate is that Medicaid is the worst form of health coverage in the country.
House Republican committee chairmen on Wednesday subpoenaed Treasury Secretary Jack Lew for documents related to ObamaCare payments that Republicans say are unlawful.
House Energy and Commerce Chairman Fred Upton (R-Mich.) and House Ways and Means Committee Chairman Kevin Brady (R-Texas) issued the subpoena for Lew and three Internal Revenue Service officials to produce documents related to financial help for people under ObamaCare known as “cost sharing reductions.”
The lawmakers are issuing the subpoena after repeatedly requesting the information throughout 2015 but being rebuffed by the administration.
After the passage of the Affordable Care Act, the federal government gave Oregon $300 million to build an online health insurance exchange. The state then hired Oracle, the world’s second-largest software company, with profits of nearly $10 billion last year, to build the website.
The website never worked. In May 2014, then-Gov. John Kitzhaber, who was running for re-election and getting a lot of heat for Cover Oregon’s failure—asked Attorney General Ellen Rosenblum to sue Oracle.
For nearly two years, Oracle has been in a bruising, $5.5 billion legal battle with the state of Oregon over who is at fault for Cover Oregon, the failed $300 million health insurance website.