Despite glitches, Obamacare’s debut reveals a strong demand

October 2, 2013 

Obamacare began. The world did not end. So far, so good.

On Tuesday, opponents of the Affordable Care Act known as Obamacare must have felt exasperated. After years of declaring that Americans didn’t want the access to health insurance provided by the law, they watched as citizens stampeded to sign up at the first opportunity. There were 4.7 million unique visitors to the federal exchange website, healthcare.gov, in its first 24 hours of operation.

On Wednesday, the crush continued, and many would-be applicants were again stymied by the glitches and backups encountered on opening day at the main ACA website. Critics said the delays showed that the law has launched a system that is so complex as to be unworkable. That verdict is based on their hopes more than the facts. Even promoters of the new system expected bugs in the first days. What they didn’t expect was the volume.

Joshua Sharfstein, Maryland’s health chief, told the Washington Post, “We had as many as 1,000 people a minute trying to create accounts.” That demand bogged down the system, he said, but added, “The silver lining is, we are certainly finding a huge amount of interest.”

Part of the difficulty wasn’t technical, but political. Many states headed by Republican governors, such as North Carolina, have resisted the ACA’s implementation, with some deliberately impeding efforts to inform the public about the law. A better-informed public would know there is no need to rush to sign up. People have until Dec. 15 to get insurance that will be effective Jan. 1. And they can delay signing up until the end of March without a penalty

People who can’t get through on the main website can get help from other sources. One is at localhelp.healthcare.gov, a website that will direct them to community groups with staff members trained to advise people on the new law. They can also find private insurance agents at National Association of Health Underwriters’ website, NAHU.org.

Many people were alarmed not by what they couldn’t find, but by what they did. There were cases of sticker shock as people who buy their own policies were told that their premiums would rocket up as a result of new requirements under the law. Much of the alarm is based on misunderstanding. While premiums may go up for some people, the ACA provides generous subsidies that will make most premiums only slightly higher or in some cases cheaper.

Wanda Stephens, an independent insurance broker in Raleigh, said that she is hearing of people upset by higher premium quotes but that those prices don’t take subsidies into account.

“I think people will be happier once they see what their subsidies are going to be,” she said. And the subsidies apply broadly. A family of four, for instance, can have a modified adjusted gross income up to $94,200 and still qualify for a subsidy.

Another upward driver of the premiums is the dynamic that underlies the ACA. It shifts costs forward by eliminating extremely high deductible plans, but on the back end it caps the amount a person has to spend out of pocket.

Some early reports on costs are simply false or misleading. Fox News, for instance, reported on a family of four that is facing an increase in monthly premiums from $334 to $965. But a follow-up report by the New Yorker magazine online found that the family could obtain insurance that, after the subsidy, would cost $320 a month – $14 less than they are paying now.

The roll-out of the ACA has had its bumps, and the effects on individual premiums will be uneven. But the law will protect against excessive premium charges and overwhelming medical bills. That’s a good thing and, with time and education, it will get even better.

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