- First, Obamacare is helping many people. In New York, for example, more than 800,000 people have enrolled through the state’s exchange. Nearly three-quarters of these were previously uninsured. In the 26 states that have expanded Medicaid, as Obamacare intended, millions of poor adults will have health coverage. In the past, federal law required Medicaid to cover only subsets of the poor.
Second, Obamacare is not helping as many people as Democrats hoped. The law is not so much a grand national leap toward universal coverage as a faltering shuffle, with each state proceeding at its own pace. Conservative governors are partly to blame—half of states decided not to expand Medicaid. Inept bureaucrats have not helped. Federal health officials deserve ridicule for their rollout of healthcare.gov, but incompetence is not confined to Washington. Just glance at the sputtering exchanges in Maryland and Minnesota, for example.
Third, the “young invincibles” are important, but not as important as you might think. Obamacare’s doomsday scenario goes as follows: if too few healthy people enroll, insurers will raise rates, which will further deter fit people from enrolling, and so on, until the insurance market collapses. Fears of this “death spiral” are legitimate. It is important to monitor how many young people sign up for coverage. However it would be misguided to overemphasise the national number of young enrollees this year.