the national interest

Libertarian Accidentally Shows How Obamacare Is Succeeding

WASHINGTON, DC - SEPTEMBER 10: U.S. Sen. Ted Cruz (R-TX) (L) and U.S. Sen. Rand Paul (R-KY) arrive for the
Facepalm. Photo: Drew Angerer/2013 Getty Images

The Commonwealth Fund has a new survey showing that the proportion of adults lacking health insurance has fallen by a quarter, from 20 percent of the population to 15 percent. (Most respondents, including 74 percent of newly insured Republicans, report liking their plan.) Also, this week, the Congressional Budget Office again revised down its cost estimates for Medicare, which now spends $50 billion a year less than it was projected to before Obamacare passed. Also, the New England Journal of Medicine recently estimated that 20 million Americans gained insurance under the new law.

The latter study comes in for criticism by Peter Suderman, Reason’s indefatigable health-care analyst. Like the entire right-wing media, Suderman’s coverage of Obamacare has furnished an endless supply of mockery of the law’s endless failures and imminent collapse. While some of his points have validity, it’s fair to say that the broader narrative conveyed by his work, which certainly lies on the sophisticated end of the anti-Obamacare industry, has utterly failed to prepare his libertarian readers for the possibility that the hated health-care law will actually work more or less as intended.

And yet, in another way, the conservative media has provided a useful lagging indicator of Obamacare’s progress. The message of every individual story is that the law is failing, the administration is lying, and so on. The substance, when viewed as a whole, tells a different story. Here is how Suderman, to take just one example, has described the continuous advancement of the law’s coverage goals:

January 21: The prognosis was so grim that Obamacare might not have yielded any net reduction in the uninsured (“it appears possible that there has been no net expansion of private coverage at all”).

January 23: The situation had grown perhaps slightly less bleak — meager reductions in the uninsured rate may have taken place (“it’s still possible that the number of people with insurance of any kind (including Medicaid) has increased, but the number of people with private insurance has not”).

February 24: It appeared that non-trivial numbers of Americans, perhaps a couple million, had gained insurance, but far less than the claimed 7 million:

We don’t know how exactly many people have gotten health coverage through Medicaid for the first time as a result of Obamacare, but the actual number is certainly much lower than the 7 million President Obama claimed

That means a significant downward revision is coming — a 20 to 30 percent reduction would bring total enrollments down to between 2.31 million and 2.64 million.

March 11: The number of newly covered had risen from the mid-2 millions to around 3 million — far less than the 13 million claimed by Obama:

instead of the 13 million people the administration the administration counts as having obtained coverage under the law, the total gain in coverage for the previously is really more like 3 million, most of which comes through the dysfunctional Medicaid system. If so, that’s not nothing, but it’s a lot less than most anyone who supported the law predicted or hoped.

July 8: A New England Journal of Medicine report that 20 million Americans have gained insurance under Obamacare, argues Suderman, is probably too high (“it’s too early to say exactly how many so far — only that 20 million is almost certainly an overstatement”).

We have gone from learning that the law has failed to cover anybody to learning it would cover a couple million to learning it would cover a few million to learning that it has probably insured fewer than 20 million people halfway through year one. The message of every individual dispatch is a confident prediction of the hated enemy’s demise, yet the terms described in each, taken together, tell the story of retreat. The enemy’s invasion fleet has been destroyed; its huge losses on the field of battle have left it on the brink of surrender; the enemy soldiers will be slaughtered by our brave civilian defenders as they attempt to enter the capital; the resistance will triumph!

Update: Gallup’s latest survey shows yet another steep drop in the uninsured rate:

Jonathan Cohn and Larry Levitt round up more evidence, which varies, but all points toward the conclusion that Obamacare has effected a significant drop in the uninsured rate on the approximate scale projected all along. You can fairly nitpick any particular measure at any given time (as Suderman and others on the right have done). But if you’re doing so in the service of an argument that Obamacare is failing in its goal of expanding you’re coverage, even if your narrow nitpicking is correct, you have misled your readers on the basic point.

Libertarian Accidentally Shows Obamacare Success