Report Card: Obamacare

Opinion by Nick Ahamed
April 1, 2014, 12:27 a.m.

Yesterday was the last day to enroll in health care without also having to pay a tax penalty for 2014.

That mile marker comes exactly six months after Obamacare was launched. How has it performed? Here, I evaluate Obama’s primary legislative accomplishment’s success for students across communication, functionality and accessibility.

Communication: B+

The Obama administration has gone to great lengths to communicate deadlines for the law and to encourage people to sign up. This communication has been especially targeted toward young people, as the participation of young Americans is important to both Obamacare’s universality and its solvency. For example, in January, popular actor Kal Penn published an op-ed on http://www.barackobama.com which targeted students and other young people. Similarly, the administration uses memes and other internet phenomena which are designed to drive engagement with young people.

Many of you likely saw President Obama’s appearance on “Between Two Ferns,” which now has almost four million YouTube views and also trended on both Facebook and Twitter. That video provided more referrals than any other source the day it was released. Thus, for outreach, Obamacare is performing exceedingly well.

However, messaging about the law’s purpose and scope could be improved, as Jimmy Fallon humorously pointed out when Obamacare was launched.

Obamacare is still unpopular according to the Kaiser Family Foundation, with 46 percent of Americans having an unfavorable opinion and only 38 percent expressing a favorable one.

However, Fallon’s point – that the popular perception of Obamacare suffers from insufficient outreach – is upheld by polling data. The Kaiser Family Foundation found that just over three-fourths of the country knew that Obamacare requires all Americans to have health insurance or pay the fine. This is surprising, considering the individual mandate is the most central and controversial component of Obamacare. Even fewer people (63 percent) knew the law provides subsidies for low-income folks to purchase coverage. Moreover, there is a clear mismatch between popularity and knowledge. More people favor aspects of Obamacare (eight of nine important parts of the law) than know that those aspects are included.

The president must continue to educate the public about the law.

Functionality: A

Despite the rocky rollout, the law has had decent success getting people health insurance. Politco reports that after yesterday, there are expected to be seven million sign-ups. As of last Wednesday, there were six million. Three million people visited HealthCare.gov by 8 p.m. on deadline day.

The data on young people for March is not yet out. However, as of February, individuals aged 18 to 34 made up a quarter of applicants. This does not include young people who can now stay on their parents’ plans until the age of 26.

Interestingly, health care exchange policies are less popular with young people than other, off-exchange policies. In fact, compared to the 25 percent figure cited above, nearly 40 percent (the administration’s goal) of individuals buying off-exchange policies are between the ages of 18 and 34, reports CNN.

Going off-exchange is important to young people because doing so will help keep prices down. But the financial future of Obamacare rests on the fact that young people, who tend to be healthier, will balance out people with pre-existing conditions. And the fewer young people that sign up, the higher the burden on those that do. Critically, the American youth must be reminded that a little sacrifice now will be repaid years down the road.

However, these positive markers have nevertheless been in line with insurance companies’ predictions. Blue Cross Blue Shield executive Ken Goulet said, “I’m very optimistic as to where we are.” Many companies are relying on the high yield of youth off-exchange policies. Cliff Gold, COO of CoOportunity Health in Nebraska stated: “We’re very glad we didn’t rely exclusively on the exchanges. It would have skewed the business older and sicker and caused higher rate increases.”

Obamacare’s mechanism is working as it should; premiums are not expected to rise because young people are signing up.

Accessibility: B-

Obamacare’s most vulnerable traits are its technological woes. Time and time again, its website, www.HealthCare.gov, has gone down (often because of too much site traffic). For young people especially, this is a huge letdown. Much of our lives take place on the web, and as students, the other resources to sign up for health care – in-person centers and phone applications – are much less preferable. Moreover, those sources too have been plagued with difficulties.

Yesterday, likely because of the deadline and heavy traffic, the HealthCare.gov website had serious glitches. As Politico writes: “The federal website was down for six hours early Monday morning. Then it was up. Then it activated its ‘virtual waiting room.’ Then it blocked newcomers from creating accounts.”

This could have financial consequences for individuals who tried to sign up before the deadline but were unable to. For an increasingly tech-savvy world, and especially for young people, the failings of HealthCare.gov are a huge faux pas that must continue to be improved. Nevertheless, the website gets a B- because it’s still handled a massive number of sign-ups and made insurance coverage possible for millions.

Final Verdict: B+

Overall, the law is performing well. American health care is much better off now than it was in 2013. The uninsured rate has continued to fall and sign-ups are surging. Nevertheless, there is still room for improvement, especially in Obamacare’s online accessibility and messaging.

Contact Nick Ahamed at [email protected].

Nick Ahamed is the Desk Editor of The Stanford Daily Editorial Board. He was Managing Editor of Opinions for Volume 246 and previously served as a political columnist. He is a senior from Minneapolis, Minn. majoring in Political Science. Contact him at nahamed 'at' stanford.edu.

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