Why did Obamacare critics think people would not sign up?

It’s remarkable what’s going on with the final signups during 2014’s open enrollment for insurance through the health marketplace.

Look at what healthcare.gov reported around 7PM on the last day of March:

Screen Shot 2014-03-31 at 7.47.13 PM

Those are BIG numbers for one day, a day that the federal website crashed due to high traffic.

And of course not all the signups are happening through this portal.

California, which already has 1.2 million private insurance signups through its state marketplace, has such volume that it’s logging off some people and telling them they have until April 15 to get coverage. That enables others to themselves log in and get their applications started.

People are waiting on lines reminiscent of Election Day so they can meet with a navigator who will help them get insurance.

And between the marketplace enrollments, Medicaid expansion and coverage for young adults, at least 9.5 million Americans have gained covered through the Affordable Care Act — before the end of March surge.

As a long piece in the Los Angeles Times reveals:

Rand has been polling 3,300 Americans monthly about their insurance choices since last fall. Researchers found that the share of adults ages 18 to 64 without health insurance has declined from 20.9% last fall to 16.6% as of March 22.

The decrease parallels a similar drop recorded by Gallup, which found in its national polling that the uninsured rate among adults had declined from 18% in the final quarter of last year to 15.9% through the first two months of 2014. Gallup’s overall uninsured rate is lower than Rand’s because it includes seniors on Medicare.

Gallup Editor in Chief Frank Newport said that March polling, which has not been released yet, indicates the uninsured rate has declined further.

Despite what some critics of the law claim, there is no credible evidence that more are uninsured than before.

So why do some Obamacare critics claim there aren’t many people who have gained coverage?

You can see one of those critics in conversation with Sen. Angus King (I-ME) on Fox News yesterday, claiming the numbers were faked somehow.

Implicit in these claims is the notion that not that many people would want to sign up for these policies.

This is a puzzle. Why would Obamacare critics think people wouldn’t sign up?

You’d think that most of those critics have health insurance themselves. Sen. Barrasso (R-WY), who was on Fox News with Sen. King, certainly does.

Given that they believe insurance is a net benefit for them and their families, why wouldn’t they believe others would want it as well?

Moreover, some critics are uninsured themselves. And it turns out that partisan identification is closely associated with what they plan on doing.

As Gallup recently showed, uninsured Republicans are half as likely as uninsured Democrats to say that they will get insurance

Indeed, a woman cited in the Republican response to the State of the Union address as suffering due to Obamacare acknowledged to a local paper, “that she could probably have lowered that figure by $100 if she bought from the state-based Obamacare exchange, but she didn’t want to do that. “I wouldn’t go on that Obama website at all,” Grenier told the paper.”

Republicans as a whole really dislike the law.

Taken together, as this graph from the Kaiser Foundation shows, Republicans are far more negative toward the law than Democrats or Independents.

Kaiser Family Foundation, March 2014 health tracking poll

Kaiser Family Foundation, March 2014 health tracking poll

This strong dislike, both among insured and uninsured Republicans, may have spilled into their perceptions of others’ views. Thus they became increasingly certain that signups would falter.

Part of these responses may be due to what’s called selective exposure — picking media consonant with their views.

Some outlets have delivered stories filled with doom and gloom for the Affordable Care Act.

This occurs even with stories about something as simple as the number of signups.

Last week it was announced that 6 million had signed up for policies through the marketplaces. This was the revised goals after the website had problems upon its launching, replacing the initial goal of 7 million for the 2014 open enrollment period.

Take a look at how this Fox News graph (via Media Matters) compared 6 million to the initial goal:

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An enrollment of 6 million is roughly 85% of the initial goal, but the graph shows it as about one-third (33%).

The numbers are accurate but the image delivers an incorrect message, that the enrollments are far below the 2014 goal.

Media choices are part of why some thought others would sign up, but it doesn’t seem like a sufficient explanation.

Surely they know people who have needed expensive care, or at least ongoing care for chronic illnesses. And surely they knew someone with a pre-existing condition who had been shut out before.

Even if one considers that people tend to associate with others who share their views, it makes me wonder why anyone would think that plenty of people wouldn’t want insurance that they hadn’t been able to get before.

Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.