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Sunday, October 23, 2016

At least 8.5 million Americans in 19 states are planning on using the Affordable Care Act exchanges to buy insurance, according to a new USA Today survey.

The newspaper contacted all 50 states for estimates of how many of their residents they expect to sign up for health insurance through the marketplaces created by the law. Though it received responses from fewer than half of the states, the estimates already surpass the seven million people the Congressional Budget Office predicted would take advantage of the exchanges in 2014.

The more people — specifically younger, healthier people — who sign up, the more likely the law is to be a success.

“[I]f the exchanges don’t enroll enough young, healthy people, insurers will have to raise everyone’s premiums,” The New Republic‘s Jonathan Cohn notes. “In the worst case, this could create what actuaries call a ‘death spiral’: Rising premiums prompt people to drop out, causing premiums to increase even more.”

The Obama administration knows that the success of the president’s signature legislative achievement depends on selling approximately three million younger Americans on signing up for the exchanges.

The Department of Health and Human Services awarded $67 million in grants to groups who will help people navigate the exchanges. That’s a fraction of the $684 million expected to be spent both federally and on the state level to make 26 million Americans aware of the subsidies available to people earning $46,000 for a single person or $94,000 for a family of four. Those earning up to 133 percent of the poverty level, $15,282, should be eligible for Medicaid, unless they live in a state where Republicans have rejected that expansion.

Conservatives are aware of how much depends on the willingness of twenty-somethings to get health insurance. Tea Party group FreedomWorks has launched an effort to encourage young people to burn their fictional “Obamacare cards” as Republican politicians are engaged in a constant campaign designed to scare young people away from utilizing the exchanges.

But if USA Today‘s survey of 19 states is accurate, the administration’s goal seems easily attainable, as California alone is expecting to sign up 5.3 million people through its exchange. The Kaiser Foundation estimated that 48 million people in America were uninsured in 2011.

“It’s not a positive development for the Republican opponents who would like to see this fail,” said Paul Ginsburg, an economist at the University of Pennsylvania’s Wharton School. “But it’s still very early in the process.”

Photo: Will O’Neill via

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  • gmccpa

    The problem with Republicans ( of the problems) is its one thing to be against Obamacare because they think it will fail. But to ‘force’ it to fail is so far over the line its ridiculous. They’ve totally lost the point of governing. The goal is not to be ‘right’…at all costs. Its to represent the best interest of the people.

    • Independent1

      Unfortunately, the vast majority of Republican legislators aren’t in the game to do what’s best for the people who voted them into office – they are there to do what’s best for Grover Nordquist and whomever bankrolled their election campagin. Why else would they sign a pledge that would prevent them from voting for legislation that is good for their constituents because it may contain a modest tax increase? And why else would they waste over 50 million dollars and lots of time voting needlessly 40 times or more to repeal a piece of legislation that has already saved the people who voted them into office money?
      Not only will the ACA exchanges discussed in this article save Americans lots of money, ACA has already been saving Americans lots of money even though virtually none of them know it. ACA has kept insurance premiums from rising 25-45% higher than they have over the past 3 years, which means that people who do have insurance and are paying say $600/mo for insurance, are saving $2,500 a year over what they would be paying today had ACA not been enacted (they would be paying $800/mo now without ACA).

    • neeceoooo

      They want it to fail because then they can say the president has failed.

  • charleo1

    Do republicans hope ACA will fail? Yes, with all the might they can muster.
    Do they hope hope it fails, in spite of the fact there are 10s of millions of
    Americans without any coverage, Absolutely they do. Do they hope it
    fails because they have a better plan, that would work more effectively.
    But, Obama and the Democrats won’t allow them to talk about it? Not
    so far as anyone knows. So, we must assume they have no plan of their
    own. Does their manic obsession with repealing the law before it takes
    full effect, have anything to do with them being pretty darn sure it will
    work? And save the public, and the Country a ton of money. And they’ll
    have to develop an entirely new obsession about stopping Obama from
    doing something else, or whatever it is he’s proposing to do? Yes.

    • neeceoooo

      They are all so focused on the President failing that they have closed their eyes to the reality of everything, whether it is the job market or healthcare reform. Makes me sick to hear them all go on and on

    • InsideEye

      Do the tens of millions know the costs of ACA. According to Kaiser Foundation, cost for salaries of 30k will be ~ 3K for premiums, plus Liability for another 6K in out of pocket expenses. Is this affordable? It is better to be on entitlement programs where you can make / rip off 50k in government payouts.

      Actuarial tables should have been already established for each financial class individual at this point. Young people are being asked to sign up for these programs and there is no true costs associated with them. These younger people and others may think that all this is free. We are going to pay for this as the remaining Working , middle class tax payers, along with the diminishing upper OnePercenter…the ” rich” …soon to be poorer. The upper 53% are paying for the ” 47 %” as usual. At least today 85% of population has healthcare, even with supposed corruption and fraud, and innovative techniques. We should only have to fix the 15% that are having a problem, rather than create another bureaucracy and have the nefarious IRS administering the medical system. They are great at keeping things under wraps!

      • charleo1

        What is lost on those, who like yourself keep insisting the plan just
        can’t work. Is we’re paying for the uninsured’s healthcare now.
        Premiums are rising, and government deficits are soaring due to
        nearly, or about, 50 million Americans without a dime’s worth of
        insurance. Accessing the medical system in the most expensive
        way possible. While many only present themselves, when they’re
        facing a crisis with their heart condition, or diabetes. And their
        bills are astronomical. It of course wipes out any savings. And
        many will live out the remaining 15 to 20 years in poverty, on
        government subsidy of some sort. Whereas otherwise they
        could have been self sufficient. These are the hidden costs, not
        taken into consideration. Created by millions of the uninsured.
        The problem with insuring the 15% with a good deal, like medicaid.
        Is the insurance cos. They foresee a stampede away from their
        shitty policies, and their ever higher co-pays, and exclusions.
        They themselves know they offer no added value to the system.
        And, they are responsible for the continued stream of negativity
        on ACA. Another subject they avoid like the plague is the implosion
        of the for profit, employer based insurance plan. Employers, many
        in a new globally competitive atmosphere, are dropping company
        plans at an ever accelerating rate. Forcing the employees, those
        who can qualify, into the private market. Where plans for a family
        of 4 can run $15,000 or more. Wages simply won’t support it.
        There is a reason every other industrialized country in the world
        has a National health plan. They faced this dilemma a long time
        before we did in a richer America. But now the world has changed.
        Jobs have changed. If we don’t want a Country where people are
        dying in the street, and disease rages through the slums of American
        Cities, we must make some changes in the way we access, and pay
        for healthcare. ACA is bastardized by the pharmaceutical corps.,
        the hospital corps, the lab corps, and so on. And relies on the for
        profit insurance cos. The best government corporate money can buy. But it will eventually increase the number of insured paying
        into the system. And that will stave off implosion for 10 maybe 15

        • InsideEye

          I do not insist that plan will not work. I personally advocate a one payer system, paid for by a National Sales tax on all goods and services bought. This would be a dedicated tax only for Social Services, health, SSN. This way EVERYONE contributes.
          People can get credit or voucher for picking what they need from an insurance company, or a single payer system. No love for insurance companies….no bankruptcy required to pay for catastrophic coverage. All this can be added to the Medicare administrative system, without creating a new IRS controlled system.

          The angst comes from populace of 53% of tax paying working middle class that is paying the costs of “47%”

          The cost of the Affordable care are have yet to be determined. By having a dedicated National Sales tax, we all pay into the system, less pain, angst, no politics. No insurance companies, and no reading a congressional bill …that no ne has obviously read…..until it was passed. Would you run your home or business like that.

          • charleo1

            I’m okay with that, certainly. The sales tax is a bit too regressive for my sense of equity. Since the lower incomes spend a far greater percentage of their earnings on the basics. But that could be remedied by changing the tax code to better match the economic system, and structure, we have in place today. Which is very different than the one in place, when much of the current tax law was written. That said, it is not my opinion that we should soak the rich to underwrite a welfare state. Far from it. But we do need to realize, in a new lower wage, service based economy, profits are distributed, or shared very differently than before. That if we are to maintain a certain quality of life, among the growing populations of workaday labor, minus the high levels of public debt. We will need to adjust taxes toward the new location of the larger proportion of wealth. Which will be much more at the upper levels, than in the middle, as it was before. Since this is heresy to large swaths of the Right Wing, at the present time. Who rail aganist both sensible tax policy, and public indebtedness. It is uncertain the 47%, which is actually
            closer to 20%, if we don’t count retirees on SS, veterans,
            the disabled, and those working for minimum wage, can
            survive the readjustment. Personally, this is my greatest
            concern. Single payer healthcare? I can’t say when. Only
            that we’ll get there. The new economy will insist on it.

          • omgamike

            I agree with most of your comment. I do not agree with a voucher system. It won’t work. A voucher is no good to you if you can’t afford to pay the difference between the amount of the voucher and the cost of a medical plan that is going to meet all of your needs. I am all for total, universal health care. A single payer system, administered by the government. It has been shown, time and time again, that Medicare is run very efficiently. Multiples of times more efficient than any private insurance company. If it took a national health tax of some sort to finance this program, then I am all for that, too. It is time to get people out of the emergency rooms and into the doctor’s offices. Emergency rooms are for emergencies, not for routine medical care, that everyone should have, at an affordable cost.

          • InsideEye

            Voucher or credits to use as needed…if you do not need pediatric or Obgyn, the you do not buy it. The costs of individual coverage for birth to death health care should be actuarially known at this point already. It should be the same price really for everyone. If we had a dedicated sales tax, no one would feel the pain financially. Some say this type of tax is regressive….. But Everyone CONTRIBUTES….takes away the animus , angst of feeling that only the Working tax payer is supporting the so called “have nots”. Seems fair to me…no more politics and corrupt PAC monies influencing / bribing congress.. Ther are no PACs for the working tax payer the 50% of us remaining out here…unable to demonstrate for our own cause because we are working……do not get me pissed off, congress…I may just go on the 50K give aways , not work and come to Washington and beat the F’n doors down….do not make me go down there, Congress.

  • dtgraham

    @ Sally Curran

    I think you can.

  • Mark Forsyth

    The republicans are DEADWRONG on this issue along with so many others.They use the fear factor to scare young folks away from ACA because,as we all know, it is the only tool they have left in their box.They discarded logic and reason in favor of convoluted thinking ages ago.Don’t expect them to admit it much less apologize.You would sooner hear an apology from the government for the genocide visited upon the red man in the name of manifest destiny.

  • Kawasaki Heavy Industries

    Conseraitive Republican Tea Party radical don’t get it what they doing. first they support Voter I.D. fraud on Republican states. So shutting down the government will make anysense during bill Clinton era. No. still Republican will get the blame for shutting down government … So they lose 2014 election. Republican should take advice from Newt Gingrich. Except embarrassed you’r – self shutting down the government.. they why democrat should do something when Republican act like children brought up shutting the government… That GOP rebranding lol. GOP should deal with healthcare in 50 states