Editorial: The Promise That Matters; Extending Health Care to All
The October rollout of the health insurance marketplaces under the Affordable Care Act has been generally characterized as an unmitigated disaster. We take a semi-contrarian view. Let’s call it a mitigated disaster.
Yes, the federal website on which 36 states rely to allow people to purchase insurance has been plagued by technical problems that so far have not been satisfactorily resolved and may not be for a while. Some of the 14 state-operated exchanges, including Vermont’s, have also proven to be somewhere between unreliable and impenetrable. Frustration abounds, and justifiably so. Obama administration officials either didn’t see it coming when they should have, or did see it coming and booted it.
But that is far from a complete picture. As a McClatchy-Tribune story in Wednesday’s Valley News reported, enrollment on some of the state-run websites is surging, including those in California, New York, Connecticut, Washington state and Kentucky. In California, for instance, 31,000 people enrolled in October, a number that was doubled during the first two weeks of November.
Moreover, 400,000 people have become eligible for coverage under expanded Medicaid programs that are a state option under the ACA. That is not an insignificant number by any means.
And while only 106,000 people nationally were able to enroll in a health plan in October, far below projections, it’s worth noting that 26.9 million visited either the federal or a state-based website during the month, 1.5 million completed applications and 1.1 million were found to be eligible to enroll.
It’s hardly surprising in the circumstances that Republicans are energetically renewing their calls to repeal the ACA. We suspect that their motivation is not, however, the stated one: that the rollout demonstrates that Obamacare can’t and won’t work. To the contrary, opponents fear that once fully established, it will work all too well, and so they feel an urgency to strangle the law in its cradle.
We do not take lightly the problems that have plagued the rollout so far, but it is important not to lose sight of the fact that they are technical in nature and do not speak to the central objective of the ACA, which is to extend insurance coverage to the uninsured. People are angry and frustrated about the websites precisely because they are so interested in enrolling.
This is not to say that the patience of potential enrollees is unlimited, and those charged with fixing the mess need to approach their task with a heightened sense of urgency. But it is worth noting that consumers of all sorts of services are accustomed to frustration when they try to use websites that don’t work as advertised — those of banks, insurance companies, government agencies, retail entities and their own companies prominently among them.
Last Sunday, staff writer Chris Fleisher profiled one Vermonter who persevered through the difficulties and finally was able to enroll through the state website with the help of a “navigator” at the Good Neighbor Health Clinic in White River Junction. What stuck with her from the experience was not the frustration, but the fact that she had signed up for better health insurance than she now has at a subsidized cost of $169 a month — down from $400 a month at present. As that experience is replicated many thousands of times across the nation in the coming months, the initial website problems will take on their proper perspective — glitches that could and should have been avoided but which in retrospect were only the birth pangs of a new and better health care world.