Health Care
1:03 pm
Sat April 5, 2014

With Enrollee Goal Met, Obamacare Still Faces Political Trial

President Obama and his supporters had a rare opportunity to celebrate this week.

A last-minute surge in people signing up for health insurance sent the total government enrollment figures over the seven-million mark.

That number seemed out of reach just a few months ago, when a crash-prone website threatened to undermine the president's signature health care law.

Republicans are still bent on repealing the law, but now millions more Americans have a stake in Obamacare's survival.

On Tuesday, the president marked the comeback. "The bottom line is this: Under this law, the share of Americans with insurance is up, and the growth of health care costs is down, and that's good for our middle-class and that's good for our fiscal future," he said.

We don't yet know how many of the new enrollees were previously uninsured, but multiple surveys show that overall insurance coverage is on the rise. Even before the surge in sign-ups over the last few weeks, Sharon Long of the Urban Institute estimated nearly 5.5 million people had gained coverage through private insurance or programs such as Medicaid.

"Insurance coverage is going up," Long says. "There may well be some people who've lost coverage. But the number of people who've gained coverage swamps that effect."

That doesn't mean the controversial health care law is out of the woods. Drew Altman, president and CEO of the Kaiser Family Foundation, says the real test is still to come, as people go to the doctor, make their co-pays, and decide whether the coverage is a good deal or not.

"When you look at the policies, there's no question but that the winners will vastly outnumber the losers," Altman says. "But we've also learned over the last year that it just takes a small number of people who view themselves as losers to make trouble for the law politically."

Indeed, Republican critics like Wyoming Sen. John Barasso continue to highlight the stories of people who've been hurt by the health care law.

"People paying more in premiums, people losing their doctors, not having access to the hospitals in their community, higher co-pay, higher deductibles," Barasso said. "That's what the American people are facing."

Republican Gov. Bobby Jindal of Louisiana offered his own, alternative health care plan this week, at a breakfast sponsored by the Christian Science Monitor. Jindal suggests offering vouchers as a substitute for Medicare and a tax break for those who buy health insurance on their own. He also wants to let the states decide how to protect people with pre-existing conditions.

"The Republican Party needs to be more than the party of no," Jindal said. "We have to have solutions. We talk about the need to repeal Obamacare and I think that's absolutely right."

But Democratic pollster Geoff Garin says repeal has just gotten more difficult. While polls show less than half the country approves of Obamacare, attitudes towards it have improved somewhat. Garin says we may have reached an "inflection point."

"I think the tables may have turned a little bit as more and more people feel they have a stake in the Affordable Care Act and who really don't want the Republicans to be taking away new rights and new benefits that they're enjoying because of the law."

Insurance companies will soon be deciding how much to charge for next year's coverage. The late surge in customers may help to limit price hikes, and perhaps boost competition. But there's likely to be wide variation around the country, and people in some areas may see much bigger increases than others.

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

Transcript

SCOTT SIMON, HOST:

President Obama and supporters of the Affordable Care Act had cause to celebrate this week when a last-minute surge in people signing up for health insurance sent the total government enrollment figures over the 7 million mark. Now that never seemed out of reach just a few months ago when a crash-prone website threatened to undermine the president's signature health care law. Many Republicans are still bent on repealing the law, but as NPR's Scott Horsley reports, millions more Americans now have a stake in Obamacare's survival.

SCOTT HORSLEY, BYLINE: This past Tuesday, President Obama welcomed the Boston Red Sox to the White House, saluting the team for winning the World Series just one year after their last-place finish. Later that day, the president marked another comeback - the government's own health insurance marketplace recovered from its terrible launch, eventually signing up more than 7 million people.

(SOUNDBITE OF SPEECH)

PRESIDENT BARACK OBAMA: The bottom line is this - under this law, the share of Americans with insurance is up and the growth of health care costs is down. And that's good for our middle class, and that's good for our fiscal future.

HORSLEY: We don't yet know how many of the new enrollees were previously uninsured, but multiple surveys show that overall insurance coverage is on the rise, even before the surge in sign-ups in the last few weeks. Sharon Long of the Urban Institute estimated nearly 5.5 million people had gained coverage through private insurance or programs such as Medicaid.

(SOUNDBITE OF INTERVIEW)

SHARON LONG: Insurance coverage is going up. There may well be some people who've lost coverage, but the number of people who gained coverage swamps that effect.

HORSLEY: That doesn't mean the controversial health care law is out of the woods. Drew Altman, who heads The Kaiser Family Foundation, says the real test is still to come as people go to the doctor, make their copayments and decide whether their coverage is a good deal or not.

(SOUNDBITE OF INTERVIEW)

DREW ALTMAN: I think, when you look at the policies, there's no question but that the winners will vastly outnumber the losers. But we've also learned over the last year, that it just takes a small number of people who view themselves as losers to make trouble for the law politically.

HORSLEY: Indeed, Republican critics, like Wyoming senator John Barrasso, continue to highlight the stories of people who feel they've been hurt by the health care law.

SENATOR JOHN BARRASSO: People paying more in premiums, people losing their doctors, not having access to the hospitals in their community, higher co-pay, higher deductible - that's what the American people are facing.

HORSLEY: Republican governor Bobby Jindal of Louisiana offered his own alternative health care plan this week at a breakfast sponsored by the Christian Science Monitor. Among other things, Jinal suggested offering vouchers as a substitute for Medicare and a tax break for those who buy health insurance on their own. He also wants to let states decide how to protect people with pre-existing conditions.

GOVERNOR BOBBY JINDAL: The Republican party needs to be more than than the party of no. We have to have solutions. We talk about the needs to repeal Obamacare, and I think that's absolutely right.

HORSLEY: But Democratic pollster Geoff Garin argues repeal has just gotten more difficult. While polls show less than half the country approves of Obamacare, attitudes towards the law have improved somewhat. And Garin says we may have reached an inflection point.

GEOFF GARIN: I think the tables may have turned a little bit as more and more people feel they have a stake in the Affordable Care Act and who really don't want the Republicans to be taking away new rights and new benefits that they're enjoying because of the law.

HORSLEY: Insurance companies will soon be deciding how much to charge for next year's coverage. The late surge in customers may help to limit price increases and, perhaps, boost competition. But there's likely to be wide variation around the country. And people in some areas may see much bigger price hikes than others. Scott Horsley, NPR News, Washington. Transcript provided by NPR, Copyright NPR.