President Barack Obama proclaimed the success of Obamacare
on Tuesday after the administration announced that 7.1 million people had enrolled in the new federal healthcare program by the March 31 deadline. But there are other, unfulfilled provisions of the law that are a more accurate measure of its success.
According to Forbes
magazine, three main areas suggest the law is not taking off. For one, the planned Medicaid expansion under Obamacare is incomplete. Just 26 states have agreed to expand their Medicaid programs and accept federal funds under the Affordable Care Act.
The law's supporters project that 4.5 million more Americans will get Medicaid coverage this year in states that have expanded their programs. But in the 24 states that have opted out, nearly 5 million will not get Medicaid, a situation that will have significant implications for the law's long-term success, according to Forbes.
"Obamacare will be a failure until Medicaid expands in red states," Alec MacGillis of The New Republic
magazine said last week.
"We have passed a law meant to expand coverage to all Americans, and yet it does not reach the poorest of our fellow citizens in nearly half the states in the country," he said.
The law also intended to introduce other reforms, such as shifting the emphasis away from fee-for-service and toward fee-for-value for healthcare providers.
Forbes suggests that, at best, it's too soon to tell whether the reforms are having their intended effect, and they could be hindering the health insurance industry.
"Experts generally believe that the healthcare sector's slowing growth (aka, "slowth") partly reflects the shift toward these models," Forbes said.
Rob Lazerow, an expert on Medicare savings programs at Forbes, said, "For many organizations, these new payment models will drive more near-term transformation than coverage expansion."
In addition, Forbes says that while the law is starting to achieve its goal of reducing hospital readmission rates, it is unclear whether that is a proxy for improving care and lowering costs.
"That's an incredibly difficult goal, of course. And it's harder to measure that than the number of people signing up through insurance exchanges. But achieving better quality at lower cost is what Obamacare is really supposed to be about, too," Forbes said.
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