The ObamaCare Debate Is Far From Over

Democrats imagine that the seven million who signed up are all happy campers.

With the announcement earlier this month that 7.1 million Americans signed up for health insurance through ObamaCare, Democrats think they are over the hump. House Leader Nancy Pelosi told CNN's Candy Crowley that congressional Democrats "are happy to not run away from what we have done. We're very proud of what we have accomplished."

Democrats at risk in Republican states this November agree. Louisiana's Sen. Mary Landrieu says ObamaCare "holds great promise and is getting stronger every day." Alaska's Sen. Mark Begich proclaims "seven million people have access to quality, affordable care and are in control of their own health-care choices."

President Obama went so far as to declare, "The debate over repealing this law is over. The Affordable Care Act is here to stay."

That's a wish, not a fact. ObamaCare is and will remain a political problem for Democrats because there's a huge disconnect between the party's rhetoric and the reality that people affected by the law have experienced.

Take the 7.1 million people who picked a policy on ObamaCare's state or federal insurance exchanges. The administration is aware that as many as 20% of them have yet to pay. The White House extended the sign-up deadline until April 15 to give more people time to navigate ObamaCare's website—and staff at the regional offices of the Centers for Medicare and Medicaid Services are pressuring anyone who has signed up to pay the first month's premium.

Even if the administration gets seven million paying customers on the exchanges, they can't assume they are all happy patrons who will vote Democratic in gratitude. Most are people whose health coverage was canceled last fall despite Mr. Obama's frequent promise that "if you like your plan, you can keep it."

A Dec. 26 Associated Press survey found 4.7 million policies were canceled last year as out-of-compliance with ObamaCare's mandates. Fox News took the AP's work and has continued updating it. As of March 6, Fox reported that the number of cancellations had grown to 6.3 million. That figure did not include policies canceled in 11 states—Arizona, Arkansas, Massachusetts, Missouri, Ohio, Oklahoma, Rhode Island, Texas, Utah, Vermont and Wisconsin—which represent 24% of the nation's population. If policies were voided in those states (which did not collect the data) at the same rate as the rest of the country, the total of canceled policies could be around 9.3 million nationally.

Most of those policyholders were happy with what they had and didn't like being forced to change. In addition, most of those policies probably covered more than one person, making the number of people adversely affected much higher than the 7.1 million number cited by the president.

That's not the only flaw in the Democrats' reasoning. Though some policyholders are getting cheaper, subsidized coverage, many newly enrolled exchange customers are likely to be paying higher premiums and deductibles than they were before, even after accounting for ObamaCare's subsidies.

In his State of the Union address, the president claimed that "because of the Affordable Care Act, more than three million Americans under age 26 have gained coverage under their parents' plans." The reference was to a provision in the law that allowed young people between the ages of 25 and 26 to stay on their parents' plan for an additional year, starting in 2010.

However, as the Manhattan Institute's senior fellow Avik Roy has pointed out, this provision had not led to an increase in the percentage of young people with coverage. According to a September Census Bureau report, "Income, Poverty and Health Insurance Coverage in the United States," the percentage of young people with private health insurance was the same after two years of ObamaCare—60.5%—as it was before the law kicked in.

There is not likely any army of grateful 25-year-olds and their parents ready to vote for Team Obama this fall.

The administration seems to inhabit a parallel universe in which their health law is a glorious success that will carry Democrats to victory in the midterm elections. In November, the real world will deliver a harsh message about ObamaCare. The debate over this unpopular legislation is far from over.

A version of this article appeared April 10, 2014, in the U.S. edition of The Wall Street Journal, with the headline The ObamaCare Debate Is Far From Over and online at WSJ.com.