This week, the health consulting firm Avalere found that only 1 to 2 million of the 6.3 million who signed up for Medicaid were new enrollees brought into the program by Obamacare. The rest were people who were eligible and would have signed up for Medicaid irrespective of Obamacare, in addition to people who were already on Medicaid but were renewing their status. (The researchers reached their conclusion by comparing the Obamacare sign-ups with a recent period before the new health law went into effect.)
Then there are the roughly three million people said to have signed up for private insurance. In mid-January, the Wall Street Journal reported that a relatively small percentage of the new sign-ups were previously uninsured Americans gaining coverage through Obamacare. The rest were people who were covered and lost that coverage in the market disruptions largely caused by Obamacare.
A McKinsey and Co. survey cited by the Journal found that just 11 percent of private insurance signups were people who previously had no coverage. Other surveys found that about one-quarter of new sign-ups were previously uninsured.
Whatever the precise number, it appears that a large majority of the activity in Obamacare private coverage sign-ups is essentially a churn operation: The system throws people out of their coverage, and then those people come to the system to sign up for new coverage, and that is reported as a gain for Obamacare.
Put the two together — Medicaid and private insurance — and it's clear the response of the nation's uninsured to Obamacare has been far less enthusiastic than the administration claims. Which means that the Affordable Care Act has gotten off to a terrible start at its core mission, insuring the uninsured.
The Congressional Budget Office has estimated there are 57 million uninsured people in the United States. Even if Obamacare worked perfectly, an estimated 31 million would remain uninsured when the law is fully in effect. And if Obamacare continues to sputter and fail as it has so far, that number of still-uninsured could be much higher. Was it worth roiling the nation's health care system to achieve such lackluster results?