Continuing his Brit’s eye view of the Obamacare initiative, Henry Vespa asks: Is it working?

The $64,000 question is, after the dust has settled, after the party political backbiting and manoeuvring, after the legal challenges, and after all the spurious stories and statements, is Obamacare actually working?

Remember, the whole point was to get more American citizens covered, for the Patient Protection and Affordable Care Act to broaden the healthcare provision (and extend Medicaid and Medicare) to some of the 50m or so Americans who had no cover whatsoever. So, here we are, halfway through 2014, something should be showing by now, right?

Well, naturally, as with all statistics-related matters, the truth is hard to find… One figure being bandied about is 7.5m – that’s apparently the number of people signed up to a health cover policy under the PPACA. Well, on the face of it, that’s 15% of the cover-less population now in a position to receive medical attention should they need it. Sounds good. Not bad considering the whole thing only really kicked in last year. But, how many of those 7.5m already had healthcare and simply took advantage of the Obamacare marketplace to grab a cheaper policy? Surely some already had coverage?

Furthermore, how many of those who’ve signed up via the fragile healthcare.gov website are still paying their premiums (how many paid in the first place?) and so are actually covered in fact? The Obama administration’s position is that it’s hard to say; too early to tell. On the other hand, some sources (the big insurance companies and brokers) say that they’ve given the White House that information and that around 15-20% of signees never paid the first premium (which would immediately reduce that 7.5m to just 6m).

Part of the problem is that much of this information is kept at a state level because practically speaking the operation and the rollout of Obamacare are carried out by state governments. Given that many of those states – especially the Republican-run ones – are less than supportive of Obamacare (more than half of the 50 joined in the legal challenges that were ultimately tossed out by the Supreme Court) and have refused to fund the wider use of Medicare and Medicaid, it’s fair to say that there are some real forces working both against the initiative’s success and against honest reporting on the matter.

Finally, there’s also the issue that, as with any insurance scam, sorry scheme, its success rests on a vast number of people paying for policies but not claiming on them. In other words, let’s be blunt, the cost of treating the elderly and/or those with pre-existing and serious medical conditions is met by having a majority of young, healthy, non-claiming policyholders on the books. So, if a significant portion of that 7.5 (6?) million are not in good health, Obamacare becomes akin to some sort of insurance black hole; it’s just a matter of time before it collapses under its own weight. Needless to say, nobody seems to have any figures related to that small matter either.