You know all those, “Ain’t it awful?” stories you’ve been hearing ad nauseam since the launch of the Affordable Care Act’s (ACA) website on Oct. 1? Expect to hear not one more word.
Now that things are working great, we’re betting that not only will you never hear again how bad they are, you will also never hear that they’re really super.
…after a concerted effort to improve HealthCare.gov, the administration said Sunday that the online Obamacare enrollment portal now essentially meets all of the previously stated goals for the website…
The site’s average response time — the average time it takes for the system to respond to an action by a user — is down from eight seconds to under one second in the past three weeks, said [Obama administration official in charge of the website Jeff] Zients. The site’s average error rate is also down, according to Zients, with the system hitting a rate of 0.75% on Friday. And the system’s “uptime,” a measure of system stability, is consistently surpassing 90%.
Republicans are already changing their message.
Replacing, “The website doesn’t work!” with, “We still hate Obamacare because…’cause, we’re Republicans!” isn’t that hard.
As the administration’s self-imposed deadline for improving the troubled site has come and gone over the weekend, Republicans on Capitol Hill have been unusually quiet, after months of frequent criticism of HealthCare.gov and of broader changes to the health insurance market taking effect because of Obamacare.
Top House Republicans took issue Sunday primarily with Obamacare’s changes to the insurance market rather than with the enrollment site’s troubled history.
“This isn’t just about a broken website, it’s about a fundamentally-flawed law,” Michael Steel, spokesman for House Speaker John Boehner, said in a statement. “Whether or not Americans can logon to Healthcare.gov, they are losing the health plans they like, the doctors they’ve always relied on, and — to add insult to injury — facing higher costs as well.”
Well, actually, on those “higher costs as well…” not so much. Nobel prize-winning economist Paul Krugman noted recently that health care costs have dropped like a stone since the ACA took effect.
Since 2010, when the act was passed, real health spending per capita — that is, total spending adjusted for overall inflation and population growth — has risen less than a third as rapidly as its long-term average. Real spending per Medicare recipient hasn’t risen at all; real spending per Medicaid beneficiary has actually fallen slightly…
Krugman added that care is improving.
So what aspects of Obamacare might be causing health costs to slow? One clear answer is the act’s reduction in Medicare “overpayments” — mainly a reduction in the subsidies to private insurers offering Medicare Advantage Plans, but also cuts in some provider payments. A less certain but likely source of savings involves changes in the way Medicare pays for services. The program now penalizes hospitals if many of their patients end up being readmitted soon after being released — an indicator of poor care — and readmission rates have, in fact, fallen substantially. Medicare is also encouraging a shift from fee-for-service, in which doctors and hospitals get paid by the procedure, to “accountable care,” in which health organizations get rewarded for overall success in improving care while controlling costs.
Furthermore, there’s evidence that Medicare savings “spill over” to the rest of the health care system — that when Medicare manages to slow cost growth, private insurance gets cheaper, too.
And the biggest savings may be yet to come. The Independent Payment Advisory Board, a panel with the power to impose cost-saving measures (subject to Congressional overrides) if Medicare spending grows above target, hasn’t yet been established, in part because of the near-certainty that any appointments to the board would be filibustered by Republicans yelling about “death panels.” Now that the filibuster has been reformed, the board can come into being.
Krugman’s conclusion, now that healthcare.gov is working great, might be too optimistic. The site is working, costs are dropping, yet there are no headlines about the triumph of Obamacare.
The news on health costs is, in short, remarkably good. You won’t hear much about this good news until and unless the Obamacare website gets fixed. But under the surface, health reform is starting to look like a bigger success than even its most ardent advocates expected.