The Not So Bad PPACA Numbers

After 10 days scurrying around the Shanghai, China area; I am now sitting in Bangkok, Thailand and reading more of the news. Such is the life of a Global Purchasing Manager dealing with automotive and industrial. I have been reading and watching the typical media reporting about the PPACA while drinking my green tea.

Greg Sargent as reported on Crooks and Liars – How the Obamacare numbers actually look pretty good picks up on what the numbers to date mean for the PPACA. So what is the big deal???

“Republicans are gleefully pointing to the numbers as proof Obamacare needs to be scrapped entirely.

That confirms two things we’ve long known to be true: the website is a disaster, and short term enrollment figures are a serious political problem for the White House and Democrats. But to Larry Levitt, a vice president at the nonpartisan Kaiser Family Foundation, another very telling number is this one: over 975,000 have been determined eligible for a marketplace but haven’t yet chosen a plan.

‘That’s one of the most telling numbers — a million people have been determined eligible,’ Levitt tells me. ‘That means if the website had been working well, and a million people had gotten to the end of the process, we’d be looking at a very different trajectory now. We heard about the surge in traffic when HealthCare.gov went live. This suggests there is in fact a lot of interest.’”

We can establish the PPACA website which was more or less designed as a backup to expected state run exchanges and did not function as expected. We can also safely say > half of the states who were supposed to have systems in place declined to implement state exchanges much less pass the PPACA. My experience as a part of multiple MRPII/ERP implementations where businesses decided to either change source code or make other extensive changes has always resulted in system issues. this leaves me to say, the crowing about commercial enterprises being far more successful in system implementations is just plain nonsense. Even so, the federal exchange was never meant to handle the traffic which showed up at its doorstep due to obstinate political and moneyed interests (such as in Michigan) who are more interested in seeing a President in failure than helping their constituents. 20 years since Hillarycare and little has happened to help the uninsured or stem the rising cost of healthcare (sans insurance).

Looking at the chart, Larry Levitt of the Kaiser Foundation points to the “975,000 being determined eligible in the marketplace but not having yet chosen a plan.

if the website had been working well, and a million people had gotten to the end of the process, we’d be looking at a very different trajectory now. We heard about the surge in traffic when HealthCare.gov went live. This suggests there is in fact a lot of interest.” A lot of interest in having some type of healthcare insurance

Because we have issues with the PPACA software; the proposal by Republicans, tea-baggers, and those who simply dislike the president is to scrap the PPACA this decade and wait for another decade or two to implement another version? Hmmmmmmmmmm, nope! There is no way another bill would get past the Republican held House in this decade. I have not participated with a commercial interest yet which has shut down when there have been software issues and we should not be so willing to back away from the PPACA. The companies worked through the issues and went onward for the most part. When the TSA was blowing $200 million a year (since 2007) trying to read your personality in conversations while you were getting x-rayed and patted down, no one was calling for an immediate halt to it. 6 years later, > $1.2 billion spent, and the TSA finally determined their Vulcan mind-meld methodology did not work. Even so, we do need to move forward much faster with a PPACA website fix.

”’Assuming the website gets fixed, I would assume a surge of enrollment in December, and another surge in March,’ KFF’s Levitt explains.”

But what about the lowly numbers (100,000) who did get insured through the state and federal exchanges? This is an extremely low number when compared to expectations for the individual market place; but, the critics and pols conveniently side step the 400,000 who were made eligible for Medicaid in states which embraced the expansion. Isn’t this about insuring more people whether through the individual exchanges or through Medicaid?

”‘In total that’s over 500,000 people who signed up for insurance in the midst of a tumultuous launch,’ Levitt says. ‘People make a distinction between the marketplace and Medicaid, but those are both elements of the Affordable Care Act — both are mechanisms to get people insured.’” 500,000 in one month?

The argument put forth by the Obama foes have been about people experiencing negative impact (as if the Republicans actually cared for their constituents as opposed to the moneyed interests) from the PPACA website failures, purposeful insurance company cancellations, and higher rates due to broader coverage. All of this is occurring in the individual market as opposed to the much larger group market. The cancellations have been made by companies, the increased costs have mostly been disproven, and the website is being worked on feverishly. Going forward, the answer to today’s issues and the success of the PPACA will be determined by the numbers who benefit from coverage. As a result, the outlook is still unsettled but positive when the entire numbers are reviewed as shown. The PPACA is moving forward albeit slower than expected. It is accomplishing at a less than spectacular rate on the exchanges what it is supposed to do . . . cover people. Given time, it will succeed.

“What the Obamacare enrollment numbers really tell us,” Greg Sargent, Washington Post November 13, 2013