Brookings Now

What Brookings Scholars Are Saying about the Affordable Care Act

Fred Dews

The March 31 deadline for people to enroll for health plans under the Affordable Care Act has passed, with the Obama administration announcing that over 7 million people have applied for health insurance. Brookings experts have long been offering ideas and analysis about health care reform, including over the past few days as this critical deadline neared, and passed by.

I’m a little worried that there’s an idea of ‘We’re all done now.’ There are still lots of people who don’t have coverage. Kavita Patel, managing director, Engelberg Center for Health Care Reform, to USA Today


Henry Aaron writes that “legal challenges to Obamacare are absurd.” In particular he shines a spotlight on the lawsuit that challenges the ACA based on the wording of the final law, that it authorizes payment of tax credits for health plans selected via “an Exchange established by a state.”

“Even the most severe critics of congressional dysfunction,” Aaron argues, “should find this sort of perversity too much to credit.”


Elaine Kamarck writes that, for Democrats “mend it, not end it” could be “the winning strategy for health care in 2014.” She compares ACA enrollment rates to those for CHIP and Medicare Part D, examines current public approval/disapproval ratings for the law, and takes a look at what some Democratic candidates are proposing to do to fix the law that Republicans are not.




What’s next for Obamacare?
” ask
Keith Fontenot
and Erica Socker. “Going forward,” they write, “how many people are newly covered because of the ACA will be a key metric to watch because it offers a better assessment of whether the health care law is meeting one of its primary goals—reducing the ranks of the uninsured.”

As with enrollment, it’s essential to remember that the ACA did not create one national exchange, but rather an exchange in each state. Even though many states opted not to run a program, the insurance products are still—with the exception of the multi-state plan program—state-specific. Expect 2015 premium increases to be mixed—for some plans and some states, premium changes may be modest, and for others more substantial. In many states, the 2014 enrollment figures suggest things will work well. However, premium changes could affect whether coverage is affordable or encourage people to switch plans, which can be disruptive. Either way, this is one issue to watch as we head into fall and the second year of the ACA exchanges. So keep your eye on the signal—enrollment and affordability—and don’t get lost in the day-to-day debate.


Larry Kocot spoke to Fox Business News for its weekly series on Obamacare. Now at week 27, Kocot wondered whether the people who enrolled in a health plan have paid their premium. “While we should be celebrating success here,” he said, “we are far from mission accomplished. We have to be careful about interpreting the numbers.” He added that “Without clear deadlines, plans could have difficulty with estimates for next year’s premiums; also, late enrollments could make May 1 coverage administration difficult for providers.”


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Fred Dews

Managing Editor, New Digital Products

Scholar commentary on Twitter includes:








Get more research and commentary on the ACA here.