To hear administration officials and their supporters in the press tell it, this is a great time for Obamacare. People who signed up for coverage are actually paying for it. More insurance companies are joining exchanges. Some consumers have more choices than originally envisioned. “The news surrounding the Affordable Care Act has been so good this week, it’s almost hard to know where to start,” wrote MSNBC’s Steve Benen in a recent post headlined “Everything’s Coming Up Aces for the ACA.”
Not so fast. Yes, Obamacare is a big help for those now receiving something substantial from the government – large subsidies for the lowest-income Americans who purchase coverage on the exchanges, free health care for people eligible for the expanded Medicaid program.
But for millions of other Americans, it’s a different story. In fact, one respected analyst worries that Obamacare, while helping some, is actually “creating a chronically uninsured class” of those ineligible for its taxpayer-paid assistance.
Of the much discussed 8 million Americans who have signed up for Obamacare, the “vast majority ... are receiving financial assistance,” according to a new Department of Health and Human Services report. What that means is this: Of the 8 million, about 85 percent, or 6.8 million, actually paid for coverage. Of those, about 87 percent, or 5.9 million, receive taxpayer-paid subsidies to help them pay.
The problem is, for those who are not eligible for subsidies, or for those eligible only for smaller subsidies, Obamacare still presents higher premiums, higher deductibles and narrow networks of doctors and hospitals. “The Obamacare plans are unattractive to all but the poorest who get the biggest subsidies and the lowest deductibles,” writes Laszewski. “The working class and middle class are not getting access to attractive benefits.”
But now comes word that very few will pay the penalty. In a recent study, the Congressional Budget Office said that of the 30 million people estimated to be uninsured in 2016, only about 4 million will be required to pay. The rest – 26 million people – will be exempt from the mandate under various regulations issued by the Obama administration.
What happens now? After Democrats finish crowing about what a success Obamacare is, it’s likely they will argue that subsidies must be extended to more and more Americans to pay for coverage that Obamacare has made more and more expensive. Republicans will resist, but at the same time realize Obamacare has changed the health care system in ways that will be difficult to overturn and hard to fix.
And for those millions for whom Obamacare is a bad deal? They’re just out of luck.
• Byron York is chief political correspondent for The Washington Examiner.