The not-so-successful rollout of the Patient Protection and Affordable Care Act has a lot of people unhappy. Millions have lost their insurance, millions can’t get insurance because of faulty exchanges, and millions are seeing rates rise and benefits fall. Obama has made a major change of questionable legality on short notice, which doesn’t seem to have pleased anybody.
In short, things are going pretty well, compared to where they may be a year from now.
Let’s start with a few facts. The market for private health insurance splits into two very unequal parts: employment-based and individual. Obama has said several times that only 5% of Americans have individual insurance plans. In reality it’s higher, but the individual market is certainly tiny compared to the 156 million Americans who have employment-based insurance.
The PPACA was initially scheduled to reshape both parts of the market, starting this year. Just a few weeks before the launch, Obama delayed the employer mandate, effectively postponing most changes to that part of the market. (Questionable legality once again, but I digress.) So everything that we’ve heard about in the past six weeks–malfunctioning federal website, malfunctioning state websites, millions losing their coverage, rising prices, people forced to switch doctors, the desperate “fix”–all of it comes from the individual market. Obama has mentioned this when discussing the cancellations: “Keep in mind that the individual market accounts for 5 percent of the population.”
So what’s going to happen when the focus changes to the employer-based plans next year? According to this chart from the Federal Register in 2010, the government expects a majority of employer-based plans to be cancelled as well. Consider the anger that’s erupted over a few million cancellations in the individual market these past few weeks. Think things will go well when 80 million or so people have their plans cancelled next year?