Consequently, the overriding task is to increase enrollment, particularly among target populations. That’s not only for the well-being of those who will get coverage but also because insurers need enough healthy people paying into the system to offset the costs of the sick. They based their 2014 offerings and premiums on estimates of what that balance would look like; if the estimates fail to match reality, financing the system could be a challenge. Halfway through the open-enrollment period, it’s past time for a sustained publicity blitz.
Outreach can’t end once people leave HealthCare.gov. As more people enter the health-care system, there will be confusion. Some might make more frequent (and expensive) visits to the emergency room rather than get a primary-care doctor. Still others might think they have coverage when they do not, perhaps because they failed to pay their insurers or because a computer bug mangled their applications. And those who have to pay more for insurance or take a cut in benefits — not everyone will win in a coverage expansion of this size — will be angry.
Through all this, observers should keep calm. The Obama administration’s success at tackling many of the tasks ahead won’t be clear for months, once the open-enrollment period ends and more numbers start coming in.