Has He Got A Health-Care Deal For You

October 23, 2013

He sounded every bit the pitchman—repeating a 1-800 number, promising that "call centers are available" and reassuring viewers "you can get your questions answered by real people, 24 hours a day." And boy was he selling: "The product is good. . . . It's high quality and it's affordable. People can save money, significant money . . . . And we know the demand is there. People are rushing to see what's available."

But this pitchman wasn't selling chamois rags to insomniacs at 3 a.m. President Barack Obama was pushing his signature legislation in the Rose Garden on Monday, frantically trying to distract attention from the disastrous rollout of the Affordable Care Act's insurance exchanges.

Mr. Obama has played salesman-in-chief before, but it was easier before his product hit the market. In August, the president devoted a Saturday radio address to promising "a new, easy way to buy affordable" insurance.

"We're well on our way to fully implementing the Affordable Care Act," Mr. Obama claimed. The experience would be easy. "You can comparison shop in an online marketplace, just like you would for cellphone plans or plane tickets," he said. Since Mr. Obama hasn't booked travel online recently, perhaps he is unfamiliar with how real websites work.

Americans, however, notice the difference. Only 12% believe the sign-up process is going well, according to a new CBS poll. On Oct. 16, Consumer Reports offered this advice: "Stay away from for at least another month if you can."

This will likely keep the Obama administration from reaching its goal of having seven million Americans (2.7 million of them young people) signed up for coverage through the exchanges when the enrollment period for 2014 ends March 31.

It will take signing up 38,461 Americans a day to reach that target. The White House refuses to say how many people have signed up so far, either because that number is shockingly low or because its screwed-up computer systems can't report it.

The Associated Press recently discovered a memo spelling out that the administration's target for October sign-ups was 494,620, with another 1.5 million enrollees before the Dec. 15 cutoff for coverage to begin Jan. 1. The October target assumes a daily pace half that necessary to reach the goal of seven million enrollees by March 31. The Dec. 15 target assumes a pace about 84% of what would ultimately be needed to reach seven million by the end of March.

It seems the administration is betting that the pace of sign-ups will increase after the holidays. But wouldn't most people who sign up do so when the program starts—now—or shortly before important deadlines, like Dec. 15 or March 31?

It's fair to assume the number of actual sign-ups today is low. Last Wednesday, Delaware announced its first enrollee (she was in the Rose Garden Monday). The same day, Alaska topped that with seven reported enrollees, while Wisconsin said that fewer than 50 people had signed up. Friday, Oregon admitted that no Oregonian had purchased a private insurance plan, while South Dakota reported 23 enrollees. This Monday, North Dakota reported 20 sign-ups to date.

With unlikely to be repaired soon, the administration might consider moving the goal posts. At a minimum, it should lower the March 31 sign-up target.

Key estimates for other important ObamaCare provisions have already been moved. In March 2010, for example, the Congressional Budget Office estimated that three million people would lose their employer-provided health insurance. The CBO raised its estimate this year to eight million, while the actuaries at the Centers for Medicare and Medicaid Services at the Department of Health and Human Services suggest that figure will be 14 million.

That's not all. Three years ago, the CBO estimated that the exchange's fiscal year 2014 outlays would be $15 billion. That has since been raised to $24 billion—a 60% jump. In 2010, the law was estimated to cost $337 billion for fiscal year 2015 through 2019. The CBO has raised that to $420 billion.

In 2010, ObamaCare's revenues for 2014 were estimated at $57 billion. That has dropped to $42 billion because Mr. Obama waived the employer mandate, along with its $2,000-per-worker fine for companies not providing insurance.

All of these numbers suggest that ObamaCare is at risk of signing up fewer people and costing far, far more than promised. If problems with the president's signature achievement persist or increase, then Mr. Obama can spin all he wants. It won't matter. There won't be a 1-800 number that can fix his presidency.

A version of this article appeared October 24, 2013, in the U.S. edition of The Wall Street Journal, with the headline: Has He Got a Health-Care Deal for You and online at

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