Against all odds and constant political warfare from the political right, the first enrollment period for the Affordable Care Act in the United States, better known as “Obamacare”, is over. Americans had until midnight on this Monday, March 31, to get a health insurance plan or face a fine.
Between six and seven million people signed up. This came as a relief for the administration who at times seemed to have spent its entire political capital to make the complex health care system work.
The mandatory insurance together with government help for those who cannot afford it, are the guiding principles of the new law – something that exists in Europe for generations.
But it was not part of the social policy fabric in the United States until the election of Barack Obama whose objective it was (and still is) to bring affordable health care to all citizens. Before Obamacare, more than 15 percent of the US population was uninsured, roughly 46 million people, by far the worst quota in the industrialized world.
Thus the Monday deadline closed an important chapter of Obama’s signature domestic achievement which has become over time one of the most polarizing pieces of social policy in US history.
Although lacking an adequate majority, Republicans in Congress have voted 50 times to repeal, delay or defund the health care law, largely on ideological grounds, turning the debates into mere propaganda trials to appeal to their conservative base.
But the biggest political threat to the law was the botched roll-out of the federal online exchange last fall, where people were to find, compare and purchase the best available health care plan for them and their families.
The technical glitches of the federal enrollment website www.healthcare.gov only fueled Republican sniping and put Democratic lawmakers and administration officials on the defensive. In an election year when Republicans believe they can win back the Senate, Obamacare will be a critical campaign issue that will mercilessly hit and haunt Democrats – or maybe not.
Some political observers point to the fact that many of the law’s positive elements will only gradually be seen by a larger public, in months, even years. That’s why the administration and the Republican opposition are already fully engaged in a spin war over numbers.
Last week, officials said that at least six million people have already signed up for insurance under Obamacare. That’s one million short of the original goal, which the White House says they are closing in on. Republicans claimed the government was “cooking the books on this”, signaling further political resistance.
According to press reports and a survey by the Rand Corporation, at least 9.5 million previously uninsured people have gained coverage. Adding to the six to seven million who have done so through the online marketplaces are others who bought other private insurance or who got insured through the Medicaid program for low income families and individuals, which has expanded under the law in about half the states.
On Monday, the HealthCare.gov site crashed again, amid a surge in traffic. It took several hours until the Health Department’s IT specialists could resolve the issue which was prompted by a record number of people trying to sign up.
Administration officials said interest was surging as the deadline neared. On Sunday, the Health Department announced two million visits over the weekend to www.healthcare.gov. In the last week alone, the call center handled a record 2.5 million calls, surpassing the 2.4 million it received during the entire month of February.
The run on HealthCare.gov came on the heels of an intensified PR push by the government’s top generals over the last couple of weeks that sent President Obama, Vice President Joe Biden and Health Secretary Kathleen Sebelius to the media frontlines.
But that was not enough. Another high-octane sales pitch by the White House involved sport celebrities, YouTube videos and paid media. The ad blitz hasn’t come cheaply. Administration officials confirmed to The New York Times that the Health Department spent $52 million to promote Obamacare enrollment from January until the end of March.
More detailed statistics about the Obamacare enrollees, thus the efforts to promote the law, are expected in the weeks and months ahead.