What would happen if we unveiled a program that looked like Obamacare, in a place that looked like America, but with competent project management that produced a working website?The words above are the key to Paul Krugman's column today, California, Here We Come?
Well, your wish is granted. Ladies and gentlemen, I give you California.
Krugman acknowledges the mess of the roll-out, but points at California as an example of how an approach like Obamacare can work, if properly managed.
He aknowledges the success in Kentucky, how NY is doing okay, and reminds us about Romneycare in MA, but that was a state with relatively few uninsured. But his focus is California. Why?
California is, however, an especially useful test case. First of all, it’s huge: if a system can work for 38 million people, it can work for America as a whole. Also, it’s hard to argue that California has had any special advantages other than that of having a government that actually wants to help the uninsured. When Massachusetts put Romneycare into effect, it already had a relatively low number of uninsured residents. California, however, came into health reform with 22 percent of its nonelderly population uninsured, compared with a national average of 18 percent.Please keep reading.
California authorities have been transparent with their data, which now shows over 10,000 people a day enrolling, and on target to meet goals for 2014. Contrast this with the Federal program, and as Krugman notes, imagine how the press coverage would be different were that data showing 100,000/day signing up.
Krugman covers what happened with John Boehner, including his office putting the healthcare exchange on hold for 35 minutes.
But there is more to California. Krugman notes a key statistic:
To work as planned, health reform has to produce a balanced risk pool — that is, it must sign up young, healthy Americans as well as their older, less healthy compatriots. And so far, so good: in October, 22.5 percent of California enrollees were between the ages of 18 and 34, slightly above that group’s share of the population.I would still like to see how much of the problem on Healthcare.gov was a result of DDOS attacks, since there is now some clear evidence that happened, fomented by right-wing web sites.
What we have in California, then, is a proof of concept. Yes, Obamacare is workable — in fact, done right, it works just fine.
And we know ALEC is still seeking ways to undermine OBamacare, including pushing state legislation that might strip licenses of insurance companies that participated in the program - although I suspect that any such attempt would create a devastating backlash, including from the insurance companies, for as Krugman notes
one shouldn’t forget that the insurance industry has a big financial stake in the success of Obamacare, and will soon be pitching in with big efforts to sign people up.California - and red state Kentucky - show that properly administered Obamacare can work, that people want better access to health insurance.
No, we do not all live in states that have chosen to make the process work.
But the kinks in healthcare.gov are being worked out.
More and more people are able to sign up.
And the subsidies are making MEANINGFUL health insurance more affordable than ever.
The question is whether the mainstream media will dig below the surface and the rhetoric to tell the real story.
In the meantime, we have models that show the approach does work.
As Krugman concludes,
Again, Obamacare’s rollout was a disaster. But in California we can see what health reform will look like, beyond the glitches. And it’s going to work.