Is it significant

The open enrollment period for the Affordable Care Act or Obamacare is over one month old and the numbers are in for that first 30 days.

When looking at the statistics for the first month of Obamacare in Idaho the grain of salt that must be kept in mind is there have been problems. There continue to be problems and those problems are not likely to be remedied soon. Those problems are primarily the fault of the federal government, but the end result is still affecting everyday citizens.

Keeping the problems in mind the numbers are not encouraging.

According to numbers released by Your Health Idaho on Wednesday, Nov. 13, the Idaho health care exchange website has been viewed 390,000 times since Oct. 1, by 75,000 individuals. The Consumer Resource Call Center in Boise has fielded 4,000 phone calls and 300 emails since the beginning of October.

When you break it down each individual person going to the website has actually gone to the website 5.2 times each. The call center averages 129 calls and 10 emails per day.

Of those 75,000 visitors to 4,753 have completed an application for enrollment. However, the 4,753 applications actually represents 10,573 insurable people. On average each application is for 2.2 people. Of those completed applications for enrollment 3,305 have qualified for the Advance Tax Credit subsidy.

Of the 75,000 individual website viewers only 6.3 percent actually apply for enrollment and do so for themselves and at least one dependent.

In what is possibly the most encouraging statistic 60.5 percent of the completed applications qualify for premium subsidies.

The most disturbing statistic is the number of policies actually purchased. With 4,753 completed applications covering 10,573 Idahoans only 338 policies have been purchased through the Idaho insurance exchange.

Only 7.1 percent of the accepted applications or 10.2 percent of people applying that qualify for a subsidy ended in an insurance purchase.

Idaho has a population of nearly 1.6 million people. Based on the numbers issued by Your Health Idaho .02 percent or one-fifth of one percent of Idahoans purchased insurance in the first month of Obamacare. At that rate it will take 500 months or 41.6 years to fully insure Idaho’s population, assuming that population stays growth-neutral until June of 2054.

Numbers are certainly a valid way to measure the effectiveness of something, but they are also difficult to understand without context.

In the case of Idaho’s efforts to comply with the Affordable Care Act there is a significant part of the population that receives health insurance through employers or other means so the number of people that actually need the access to health insurance is smaller than the general population of the state.

However we need to consider, what is not included in the statistics released on Wednesday. What was not part of the numbers is how many Idahoans qualifying for Medicaid. The unfortunate part of not having the number of people qualifying for Medicaid is there is no way to measure the crack in the Idaho system.

For many states the first step in the Obamacare process was to expand Medicaid eligibility to 143 percent of the Federal Poverty Line while Idaho decided to leave that eligibility cutoff at 100 percent. The important thing that needs to be measured is how many people are paying for insurance in Idaho compared to other states. Are these people or families the ones receiving the subsidy and is it enough to close the gap between the most needing group and actual coverage.

The stated purpose of the law is to create access and affordability for those that need coverage the most. However Idaho has done a huge disservice to those that fall into the gap between 100 percent and 143 percent of the federal poverty line if the numbers are not gathered because the law is federal. When the people in Washington D.C. look at the numbers and see a significant amount of help being given to low income families they won’t be looking state-by-state, they will be looking at the country overall. Idaho does not have a significantly large enough population as a whole to create a statistical anomaly in a national picture. The impact is even smaller when the number of people being counted (if they are counted) is reduced to just the lower income families in Idaho.

With a social service law like this the defining metric is significance. How many people can the law help? There are always a group of people that will not be helped by any law, but the game is always about helping as many people as possible. Idaho may not be helping the targeted population intended.

Speaking of significance, after the first month it may not  be strictly fair to ask if the Affordable Care Act is truly effective, but time is short and at the national level only 106,000 Americans signed up for coverage in the first month. That is about 20 percent of the President’s goal of 500,000 newly covered people in the first month. Only 27,000 of those 106,000 used so the website only helped 25 percent of those that are attempting to gain coverage.

On the other hand the time is short for those wanting to comply with the law and avoid the associated penalties of missing the deadline. According to the Affordable Care Act to avoid the fines a person must be covered with an active policy by Jan. 1, 2014, this means that a policy must be picked, purchased and the first premium paid by Dec. 15, 2013.

I am willing to give the philosophy behind the law a fair chance, but the law is not giving Americans a fair chance with only 25 days left to find health coverage.

I stand wholeheartedly behind my statements in this column two weeks ago. It is reassuring that the people on the ground at the Idaho exchange are honestly interested in helping Idahoans, but time is not on our side.

I also agree with Gov. Otter. There needs to be an extension of the deadline. The deadlines of this law combined with absolute failure of the federal government to implement an effective compliance method amount to nothing less than a trap.

This law is not significantly and cannot significantly be capable of insuring people before fines are imposed. At the rate of enrollment, the legacy of the Affordable Care Act seems to be heading toward one of extortion.

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