If Republicans do manage to repeal ObamaCare, it’ll go out with a whimper rather than a bang. For the fourth straight year, enrollments on the ACA exchanges failed to meet projections — both original and adjusted projections from the Barack Obama administration. In fact, 2017 enrollments fell short of 2016’s:
About 12.2 million people signed up for ObamaCare plans during the 2017 enrollment period, the Trump administration announced Wednesday.
The total falls short of the Obama administration’s projected signups of 13.8 million people, and is slightly down from the 2016 enrollment period, when 12.7 million people signed up for plans.
The Associated Press tried mightily to find the silver lining in the four-year cloud:
BREAKING: Government says more than 12 million people signed up for coverage under `Obamacare' even as Congress debates repeal.
— The Associated Press (@AP) March 15, 2017
Why frame the story in that manner? Only 31% of the enrollees were new, according to The Hill’s look at the data, and the lower number means a lot of previous enrollees had not signed back up despite being required by federal law to do so. Perhaps “Twelve million people comply with mandate while millions more defy it” isn’t a terribly compelling tweet for “BREAKING” news, but at least it would be a little more accurate.
Not surprisingly, some media outlets are pointing the finger at GOP repeal efforts:
Enrollment in the Obamacare insurance marketplaces fell by 500,000 this year to 12.2 million people, the Trump administration reported Wednesday.
The 4-percent decline suggests the GOP efforts to repeal the Affordable Care Act and Trump’s decision not to enforce the law’s individual coverage mandate convinced many Americans not to bother signing up this year.
Actually, the decision not to enforce the mandate came very late in the enrollment cycle. Enrollments began on November 1 and continued through January 31st, and the executive order from Donald Trump allowing enforcement of the mandate to be waived didn’t come until January 21st, leaving only ten days for that to have any impact on enrollments. For all but ten days of the 90-day enrollment period, the mandate was very much in place, and yet there wasn’t a rush to jump into the ObamaCare risk pool.
Democrats had also complained that Trump’s decision to cancel advertising in that final ten days also soured the end result, but that hardly explains four years of tepid enrollments. Let’s not forget that the same Democrats (and media) pushing this line insisted that enrollments would have reached 24 million by this same time, projections that grossly overshot reality. Whether the TV had advertisements or not, a plethora of news stories on enrollment efforts appeared in local news reports as well as national outlets, so awareness wasn’t exactly an issue.
Besides, the GOP has made repeal of ObamaCare the centerpiece of their election efforts since the 2010 midterms. People elected Republicans to repeal ObamaCare, and finally got all of the elements in place to do so in November. Blaming a 4% drop on chronically underperforming enrollments on Trump being in office and Republicans coordinating efforts to make good on that promise puts the cart before the horse.
Now that they have the chance, the Wall Street Journal editorial board warns, they’d better make good on it. Even if the AHCA isn’t all they want, the editors argue, it’s a good first step and a way to demonstrate credibility:
The CBO is not omniscient, but if its projections are even close to accurate then ObamaCare repeal and replacement is the most significant government reform in perhaps three decades. Under conventional (static-revenue) scoring, the bill cuts spending on net by $1.22 trillion and eliminates a raft of new taxes worth $883 billion through 2026.
Despite this tax reform and new refundable tax credits for individual insurance purchases, the bill still reduces the deficit by $337 billion. Reducing spending, the tax burden and further debt generation is an enormous pro-growth fiscal bonus. …
Conservative critics are discounting these and other benefits because the bill isn’t everything they imagine, but they’re missing the larger and rarer opportunity. ObamaCare was designed to expand over time, reaching deeper and deeper into the middle class and displacing ever-more private health insurance. This private market decomposition has been slower than expected because the Obama Administration botched the law’s design.
But if ObamaCare continues on present trend, the result will inevitably be much higher levels of taxation across society. As the entitlement state’s obligations consume more GDP, the economy’s long-term growth trend will further decline and there will be fewer jobs, as the European welfare-state experience demonstrates.
If conservatives fumble this repeal-and-replace moment, they won’t get another chance. And they’ll have squandered their best opening in a generation to control the size and scope of the federal Leviathan.