Given the grief it has taken since October and what it acknowledges was a problem-plagued start to the Affordable Care Act, the White House’s trumpeting of the fact that some 7 million people had signed up for health insurance via the federal or state exchanges by the March 31 deadline was understandable. As is usually the case, however, a single statistic rarely tells the full story. The White House’s reluctance to share the details surrounding who is signing up for coverage under ACA is further clouding the issue. One thing that remains to be seen is how many of the people who signed up for coverage will actual pay the premiums or just wanted to be able to tell the IRS they have coverage to avoid the tax penalty under the individual mandate. Another factor is the age of the people being covered. Everyone acknowledges that for the ACA to work, a lot of healthy young people are going to have to pay premiums and not file claims to subsidize the care of older and sicker people. In addition, how many of the young people now being covered won’t help with the subsidy because they have chronic health problems that will generate big claims? Then there is the question of how many of the 7 million people signing up for health insurance via the exchanges previously didn’t have insurance.
The main question all along has not been whether people without health insurance should be covered. The question is what is the best way to do that. At this point that question remains unresolved.