The State of Obamacare

by Paul Krugman


November 20, 2013, 11:02 am 13 Comments

The State of Obamacare

I haven’t been writing about the healthcare.gov thing, for the simple reason that I have nothing to say. What’s going on isn’t a policy question: we know from the states with working exchanges (including California) that the underlying structure of the law is workable. Instead, it’s about an implementation botch, which is an incredible mess, and reflects very badly on Obama. But the future of the reform depends not on policy per se but on whether the IT issues can be fixed well enough soon enough, a subject on which I have zero expertise.



Of course, that hasn’t stopped other people from breathlessly commenting on every twist and turn in the polls, every meaningless vote in the House, and so on. Hey, it’s a living.



But at this point there’s enough information coming in to make semi-educated guesses — and it looks to me as if this thing is probably going to stumble through to the finish line. State-run enrollments are mostly going pretty well; Medicaid expansion is going very well (and it’s expanding even in states that have rejected the expansion, because more people are learning they’re eligible.) And healthcare.gov, while still pretty bad, is starting to look as if it will be good enough in a few weeks for large numbers of people to sign up, either through the exchanges or directly with insurers.



If all this is right, by the time open enrollment ends in March, millions of previously uninsured Americans will in fact have received coverage under the law, and reform will be irreversible. Obama personally may never recover his reputation; Democratic hopes of a wave election in 2014 are probably gone, although you never know. But anyone counting on Obamacare to collapse is probably making a very bad bet.