“There’s been quite a bit of bad news about Obamacare in recent weeks:
•a SCOTUS smackdown on the contraception mandate overreach,
•the possibility of an even more momentous court decision being handed down next week,
•worrying signs of more rate shock to face Exchange plan buyers next fall, with many states seeing double-digit premium increases, and
•a bleak picture of Obamacare’s unfolding fiscal disaster.
In that context, it should be no surprise that progressives are cheering the purported good news that the number of uninsured appears to be declining since last summer:
•A Commonwealth Fund survey released in June shows 9.5 million fewer uninsured adults age 18 and older;
•A RAND survey released in April found a decline of 9.3 million uninsured non-elderly adults;
•An Urban Institute survey released in June shows a decline of 8 million uninsured non-elderly adults, and
•Gallup shows a decline in the percentage of adults (18 and older) who are uninsured of 3.7 percentage points since the fourth quarter of 2013 (equivalent to 8.8 million adults[1]).
As Jonathan Cohen snarkily concludes: “Obamacare Haters, Your Case Just Got Weaker.” I don’t view myself as an Obamacare hater, but I freely concede I am a great Obamacare skeptic. Let’s unpack the available evidence to see what we really know (and don’t) about Obamacare’s impact on the number of uninsured.
My conclusion is that anyone who says they are certain we have hit the CBO target of a 12 million reduction in the average daily number of uninsured in 2014 has cherry-picked the evidence.”

“About 5 percent of Americans who were uninsured last year got coverage in 2014, and more than half of those — about 2.8 percent of the population — obtained their plan through an Obamacare exchange, according to a Gallup poll released Monday. The poll, taken after the close of the first enrollment season, pegged the uninsured rate at more than 13 percent.”

“Congressional budget scorekeepers estimated Thursday that only a fraction of the people without health insurance in 2016 will actually pay a penalty under ObamaCare’s individual mandate.

In a new analysis, the Congressional Budget Office (CBO) said only 4 million of the 30 million who are expected to be uninsured in 2016 will pay a fine.”

“Indiana Gov. Mike Pence on Thursday said he wants to use Medicaid funding under the federal health-care law to expand coverage in his state, but that any expansion of it would have to come on his own terms.

The proposal is the latest from a small group of mostly Republican governors pursuing alternative ways to tap billions of dollars in federal Medicaid money available under the Affordable Care Act. Most GOP governors are refusing the additional federal money outright, while those who have wanted to expand Medicaid faced objections from GOP-led legislatures.”

“Massachusetts pioneered universal health care in 2006. Under then-Governor Mitt Romney, it was the first state to guarantee access to insurance — and drove its uninsured rate down to just 4 percent.

Which makes it baffling that Massachusetts did arguably the worst of any state in implementing Obamacare. Like a handful of ardent Obamacare supporters in other states, Massachusetts officials tried to pull off an ambitious launch — and failed badly.”

“A few months into Obamacare’s coverage expansion, there’s been plenty of debate about where the millions of newly insured have obtained coverage — whether through the law’s exchanges, directly from an insurer, through expanded Medicaid or through an employer. The health-care law’s immediate impact is a little more clear in hospitals, which are starting to report who’s coming through their doors during the first months of expanded coverage under the Affordable Care Act.”

“In the midst of all the turmoil in health care these days, one thing is becoming clear: No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.”

“Whenever somebody says that an argument is settled, you can be sure that it is not. If it were settled, there would be no need to say so. No president will hold a press conference to announce that the argument over the prohibition of alcohol is settled, precisely because it truly is settled. So when President Obama declared the debate over his health-care law “settled” and “over,” as he did at an April 17 press conference, his performance was self-refuting.”

“A left-leaning think tank whose research is often taken seriously by backers of the health-care overhaul has published a paper suggesting the administration should scrap the health law’s requirement that employers offer coverage or pay a penalty.”

The federal government will bear a disproportionate burden of premium increases in states with high rates of subsidized enrollees. Double digit premium increases are likely in many markets in 2014. Age distribution among enrollees varies by state, which may influence plans’ interest in each market.