As the deadline to sign up for an insurance policy that takes effect in 2014 passes on December 23, the next crucial step in the debate about the future of the Affordable Care Act begins.
On January 1, Republicans will make the case that because of the estimated five million cancelation notices that went out last year, more people are uninsured under the president’s signature legislative accomplishment than newly insured.
The White House is preparing to rebut that argument aggressively. Last week, an administration official asserted that only about 10 percent of those who received those notices had not found a replacement plan, as most were offered another option by their current insurer. The remaining 500,000 or so have been offered a special exemption from the individual mandate.
But it will be almost impossible to know right away if the number of net insured went up in January, The Washington Post‘s Sarah Kliff explained on Friday.
“It’s the exact opposite of weather forecasting,” Stan Dorn, a senior expert at the Urban Institute, told Kliff. “There, you can be pretty confident of what will happen tomorrow but no idea about the future. Here it’s the reverse: Over time there will be significant gains, but that will take years, not months.”
All we have now is estimates, as some states are reporting signups and some are announcing actual enrollment numbers. As of Friday, 3.3 million people had signed up for insurance through the Affordable Care Act, with at least 970,000 of them having enrolled in private insurance plans, according to ACAsignups.net.
But these numbers don’t tell the whole story, Campaign for America’s Future’s Dave Johnson points out:
—71 million Americans on private insurance have gained coverage for at least one free preventive health care service such as a mammogram, birth control, or an immunization in 2011 and 2012. In the first 11 months of 2013 alone, an additional 25 million people with traditional Medicare have received at least one preventive service at no out-of-pocket cost.
—Up to 129 million Americans with pre-existing conditions—including up to 17 million children —will no longer have to worry about being denied health coverage or charged higher premiums because of their health status.
—Approximately 60 million Americans have gained expanded mental health and substance use disorder benefits and/or federal parity protections.
—41 million uninsured Americans will have new health insurance options through Medicaid or private health plans in the Marketplace. Nearly 6 in 10 of these individuals could pay less than $100 per month for coverage.
—Consumers have saved $5 billion over the past two years due to a new requirement that insurance companies have to spend at least 80 percent of premium dollars on care for patients (at least 85 percent for large group insurers). If they don’t, they must send consumers a rebate. In 2013, 8.5 million enrollees will receive rebates averaging $100 per family.
—Insurance companies must submit premium increases of 10 percent or more for review by experts. In 2012, 6.8 million Americans saved an estimated $1.2 billion on health insurance premiums after their insurers cut back on planned increases as a result of this process.
—Since the health care law was enacted, more than 7 million seniors and people with disabilities have saved an average of $1,200 per person on prescription drugs as the health care law closes Medicare’s “donut hole.”
—Over three million young adults have gained health insurance because they can now stay on their parents’ health plans until age 26.
—Individuals no longer have to worry about having their health benefits cut off after they reach a lifetime limit on benefits. Starting in January, 105 million Americans will no longer have to worry about annual limits, either.
—Using funds available through the Affordable Care Act, health centers are expanding access to care by building new sites and renovating existing sites. Health centers served approximately 21 million patients in 2012.
The millions and millions of people who’ve been helped by the law won’t be counted as the press tries to game out if Obamacare will reach the seven million private insurance signups the Congressional Budget Office predicted for its first year. But they’re definitely out there, and they’d be among the millions who would be affected if the GOP is ever successful in repealing the law.
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