Welcome to a Healthier Year! (Guest Post)

In 2012, more than 50 million Americans lacked any form of health insurance. The Affordable Care Act was enacted into law in order to reduce that number. This website aims to give an accurate picture of how much.

In April this year, after the six-month open enrollment period has ended, it will be interesting to examine the statistics. Foremost among those numbers, in the minds of political pundits, will be how many Americans enrolled in private health plans? We will then know whether we reached, surpassed or fell short of the 7,066,000 enrollments projected by the Congressional Budget Office – long since elevated to a “target” rather than the projection it was.

How many more people are insured?
As we start this new year, at least 2.1 million people will be covered by new private plans, roughly 30 % of CBO’s first-year projection. However, this is by no means the only key figure. More than 4 million people are embraced by the Medicaid expansion. In addition, an estimated 3.1 young adults are now insured though their parents’ health plans. That adds up to 9.2 million people, which is a respectable start and should significantly reduce the number of uninsured. However, it must be underscored that many complex factors make it impossible to quantify that reduction, at least for the time being.

On top of that are an unknown number of people who have purchased ACA-compliant insurance plan off-exchange, i.e. directly from the insurance company. There are strong indications that total is significant – and we’ll return to that issue.

In three more months it will be interesting to examine: How many more Americans now have healthcare plans? But I believe it is far more important is to ask, both now and in April: How many Americans still lack affordable health care and how do we best reduce those numbers?

I know it is a question of differing political visions. In my ideology, affordable healthcare should be a right, not a privilege. Others believe that government should play no role whatsoever in the healthcare and well being of its citizens, other than securing borders and American interests abroad.

The bottom line
Let us for a moment step back from that irreconcilable philosophical conflict and ask another question: Are we paying too much for our health care? I believe we are almost unanimous in our response: Yes!

Regardless of our political leanings and our opinion on who should pay the bill, we agree that healthcare is too expensive. A special March issue of Time magazine examined the topic: Why Medical Bills Are Killing Us. What Steven Bill unearthed was depressing, but it also indicated possible ways for us to reduce that cost – for individuals, and for the country as a whole.

As a European, I have long been puzzled by how much more money Americans spend on health care – on average 30–70 % more per capita than comparable Western nations, many of which have far higher costs of living. The cost of American healthcare has far outpaced inflation, to the extent that it now swallows up 18 % of the GDP.

In 2009, for 62 % of the estimated 1.5 million Americans forced to declare personal bankruptcy, the underlying cause was a health care bill they could not afford to pay.

Undisputable facts
Charles Gaba’s ambition, and the whole intent of ACAsignups.net, has been to make a meaningful contribution to the ongoing political debate by putting “just the facts” on the table. In fact, you can verify the total yourself; every single data point is linked to its source. If you find an error, by all means bring it to our attention.

When HHS released its end-of-November enrollment figures, we saw that ACAsignups.net was accurate to within 1 %. As December drew to a close, and HHS announced that there were 2.1 million signups, ACAsignups.net had a tally of 2,106,685 private enrollments. That is not a bad match!

We believe in Senator Daniel Patrick Moynihan’s quip “you’re entitled to your own opinions, but not your own facts”. It has been depressing to witness a public debate where talking points are shouted out with blatant disregard for reality.

Now, however, it is heartening to observe that some of the shouters are falling silent. It is satisfying to see that fewer false data is spouted and that facts are not quite as often being denied.

What about the big guns?
Why is ACAsignups.net being run by Charles Gaba and other volunteers, including myself? Why hasn't a major media outlet made an endeavor to keep a running, daily (or at least weekly) total of ACA enrollments? Why is news routinely reported uncritically and without context? When HHS announced that there had been 1.1 million signups through HealthCare.gov as of December 24th, many news organizations didn't bother to emphasize that this was only half the picture (or more accurately, 55.5 % of the picture). There was little mention of the fact that 14 states running their own exchanges and accounting for 44.5 % of the CBO’s enrollment targets had close to a million enrollments – with California alone accounting for 400,000.

Just the facts
However, in the months ahead, at least you can look to ACAsignups.net for one thing: an honest and accurate state-by-state tally and running total of ACA enrollment data, where you can check every data point for yourself. We’ll also examine the trends and look behind the scenes at what this data really means.

Let’s have a fruitful debate about health care in America – but let’s be honest about the basic facts. If we can help ensure that there is no need to argue about the actual enrollment data, then our mission is accomplished.

Have a Happy New Year, and a healthy 2014!