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Obamacare still short of its enrollment targets

Puneet Kollipara

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March 12, 2014

Welcome to Wonkbook, Wonkblog's morning policy news primer by Puneet Kollipara. Send comments, criticism or ideas to Wonkbook at Washpost dot com. To read more by the Wonkblog team, click here.

Wonkbook's Number of the Day: 942,000 and 4.2 million. That's the number of people who picked a health care plan through the Obamacare exchanges in February and in all months, respectively.

Wonkbook's Chart of the Day: Obamacare enrollment is still at 75 percent of the projected level.

Wonkbook's Top 5 Stories: (1) New Obamacare enrollment data; (2) first NSA, now CIA; (3) GM recall investigations ramp up; (4) Democrats keep up populist push; and (5) deal reached on housing reform.

1. Top story: Does Obamacare have a young-adult enrollment problem?

Enrollment pace slows in February; young-adult enrollment didn't change. "The pace at which Americans signed up for health plans slowed last month in the fledgling federal and state insurance marketplaces, according to new government figures showing that slightly fewer than 1 million people enrolled in February. The Obama administration said 943,000 Americans selected health plans, compared to 1.2 million in January. Overall, enrollment stood at 4.2 million as of the end of last month. Contrary to the Obama administration's expectations, fewer people chose health plans last month than in either January or December. Contrary to the Obama administration's expectations, fewer people chose health plans last month than in either January or December. And the proportion of young adults -- a critical demographic if the marketplaces are to function well -- did not increase compared with January. The enrollment tallies suggest that administration officials and their allies, who have undertaken a blitz of outreach activities, face a significant challenge in reaching their enrollment goals by March 31, the end of the initial six-month sign-up period." Sandhya Somashekhar and Amy Goldstein in The Washington Post.

Read: The enrollment report.

Explainers:

Obamacare enrollment drops off in February. Jason Millman in The Washington Post.

Facing Obamacare enrollment deadline, these states are pushing for more time. Jason Millman in The Washington Post.

Fact-check: Julia Boonstra's claim her Obamacare plan is 'unaffordable' gets downgraded to Three Pinocchios. Glenn Kessler in The Washington Post.

Interactives:

Chart breaks down health care enrollment by state. The New York Times.

Explore Obamacare's subsidies. Christopher Weaver in The Wall Street Journal.

Obama sought to boost youth enrollment by going on Galifianakis' show 'Between Two Ferns': "President Obama stormed the internet Tuesday with his appearance on Zach Galifianakis's beloved series Between Two Ferns. There are (in my opinion) some solidly entertaining moments here, but of course Obama's reason for appearing is to work on selling Healthcare.gov and the Affordable Care Act. And of course, reactions to the video have mostly split along predictable lines -- mainstream and liberal media swoon, conservatives scoff." David A. Graham in The Atlantic.

And it seemed to be working, at least initially: @HealthCareTara: FunnyorDie.com is the #1 source of referrals to http://HealthCare.gov right now.

Video: Obama goes "Between Two Ferns." Aaron Blake in The Washington Post.

Poll: Support for Obamacare slightly edges up. "Nearly all of the increased support comes from upper-income and college-educated Americans. According to the poll, 39% of Americans say they support the health care law, up from 35% in December, a record low in CNN polling. The uptick of four percentage points is within the survey's sampling error. Fifty-seven percent of those questioned say they oppose the measure, down five points from December." CNN Political Unit.

But with GOP special election win, is Obamacare still an electoral liability? Hard to say. "This was a race that most political observers expected Sink to win. Jolly was a lobbyist -- not exactly the best profession in this political environment -- who was decidedly unproven as a candidate. He had to beat back a sitting state representative in a primary that drained his resources to the point where Sink was able to drastically outspend him. And, he did spend the entirety of the race bashing Obamacare, the issue that Republicans insist will be their silver bullet issue in the fall. All that said, special election are, well, special. They are, typically, the only election on the ballot in a district -- an occurrence that doesn't come close to approximating what the ballot will look like in November. And, they are almost always on days when elections are not usually scheduled, meaning that turnout patterns are wacky....Elections have consequences. Whether or not what happened Tuesday in Florida is a bellwether of anything, it will unnerve Democrats and energize Republicans. And, that matters." Chris Cillizza in The Washington Post.

Signs of new cooperation on health care? "In a rare instance of Senate Democrats and House Republicans working together, Congress agreed Tuesday to shift funding formerly allocated to presidential conventions to programs focused on pediatric medical research....The path to passage in the Senate was difficult, with Democrats wanting to boost cancer research by increasing NIH funding beyond the amount designated in the bill. It moves $126 million, over 10 years, from a fund for political conventions toward the NIH's Common Fund, which promotes research of cancer and other diseases." Robert Costa in The Washington Post.

The parties also came together on an Obamacare tweak. "House Democrats joined Republicans on Tuesday to pass legislation that would expand an exemption under ObamaCare for people who don't want health insurance for religious reasons. Its easy passage by voice vote sets up the possibility that it could be considered by the Senate, unlike the dozens of other bills that were mostly supported by Republicans and then ignored by Senate Democrats." Pete Kasperowicz in The Hill.

McARDLE: Obamacare needs help, and fast. "Overall, it's not a completely awful report: Enrollment seems to have held steady at roughly its January pace. However, it was supposed to accelerate. Even more worrying is the lack of significant improvement in the demographics. Unless we get a huge rush of young people signing up at the last moment -- which is entirely possible -- the insurance pool is going to be much older than expected, and that probably means it will be much more expensive than projected. In that event, either the federal government will have to make big payments to insurers through its risk-adjustment programs, or the price of policies will probably rise significantly next year." Megan McArdle in Bloomberg View.

JAPSEN: But is there a silver lining for Obama administration on young-adult enrollments? "Young adults account for 27 percent of 'marketplace plan selections' during February, the fifth month, which was consistent with January signups and three percentage points higher 'than their share of plan selections during the first three months,' the report said. At the same time ... the proportion of older adults who are 35 years of age or older, has 'continued to decrease,' the enrollment report said. This will be good news for insurance companies, which have already been telling Wall Street analysts and investors that the risk profile of those signing up has been about what they predicted, an indication that health plans should be able to manage the expenses of those who have signed up." Bruce Japsen in Forbes.

FLAVELLE: Maybe the age distribution isn't all that important after all. "The age distribution may not be as important as it seems either. Even if the Barack Obama administration falls well short of its goal of about 40 percent of enrollees being young, what matters is the assumptions insurers made in setting their premiums. If insurers guessed the 40 percent figure was too rosy, then missing that threshold won't hurt premiums. And what if everything still goes wrong -- if enrollment remains far short of target months from now, and if the age balance is far enough off to drive up premiums? Then the provisions in the law tenderly known as the three R's -- risk corridors, risk adjustment and reinsurance -- kick in to stabilize premiums, at little or no cost to taxpayers." Christopher Flavelle in Bloomberg View.

COHN: We're still missing some key enrollment numbers that matter. "The kind of data everybody craves -- about exactly how big a difference Obamacare is making in the lives of ordinary people -- is not going to be available for some time. Until then, assessments of Obamacare's progress will inevitably involve a lot of guesswork." Jonathan Cohn in The New Republic.

PHILIP KLEIN: Obamacare numbers vary widely by state. "The extreme cases of Connecticut and Massachusetts demonstrate the wide variation among states when it comes to signing up for Obamacare, variations that cannot be explained merely by population size or which political party is in charge. The variation is important, because for all the attention given to the national numbers, the success of Obamacare will hinge on how it's doing at the state level. Each individual state has its own risk pool and that pool must have a critical mass of participants and enough young and healthy enrollees to be sustainable." Philip Klein in the Washington Examiner.

Top opinion

MILBANK: Allegations of CIA spying on Senate deserve investigation. "President Obama's foes have been trying for years to uncover scandal in his administration. But the most damning allegation of wrongdoing was leveled on the Senate floor Tuesday morning -- by a friend....Feinstein is owed much more than an apology. The White House needs to cough up documents it is withholding from the public, and it should remove the CIA officials involved and subject them to an independent prosecutor's investigation. " Dana Milbank in The Washington Post.

THE GUARDIAN: The CIA: the double life of Dianne Feinstein. "Senator Dianne Feinstein is frequently exasperating. The Democratic senator from California is one day ultra-liberal, in the lead in calling for gun reform. The next she is ultra-conservative, one of the staunchest defenders of the embattled National Security Agency. The senator's contradictory nature was on show for all to see on Tuesday....It is about time Ms Feinstein used her powers as the democratically elected head of the intelligence committee to question the NSA with the same vigour -- or even a small part of it -- that she is displaying towards the CIA. That would, indeed, be a defining moment for the oversight of the US intelligence community: all of it." The Guardian.

FRIEDERSDORF: Decline of the American war hawk -- David Brooks and others just don't get it. "Americans who want the U.S. less engaged in world affairs are saying no more than what Brooks, for reasons I can't fathom, finds 'amazing': that there are limits to the changes that American politicians and soldiers can bring about, and that those limits ought to be obvious to anyone looking at Iraq, or Afghanistan, or Ukraine. This point is being made with increasing insistence by the American public because they perceive, correctly, that there is a cadre of Washington, D.C. insiders -- bureaucrats, military contractors, think tank fellows, editors like Bill Kristol, writers like Max Boot -- so oblivious to America's limits that they can't even see the last military intervention that they successfully advocated as a mistake, even though, in that case, the catastrophic results have already played out." Conor Friedersdorf in The Atlantic.

THE WALL STREET JOURNAL: Obamacare's secret exemption. "ObamaCare's implementers continue to roam the battlefield and shoot their own wounded, and the latest casualty is the core of the Affordable Care Act -- the individual mandate. To wit, last week the Administration quietly excused millions of people from the requirement to purchase health insurance or else pay a tax penalty. This latest political reconstruction has received zero media notice, and the Health and Human Services Department didn't think the details were worth discussing in a conference call, press materials or fact sheet. Instead, the mandate suspension was buried in an unrelated rule....Keeping its mandate waiver secret for now is an attempt get past November and in the meantime sign up as many people as possible for government-subsidized health care. Our sources in the insurance industry are worried the regulatory loophole sets a mandate non-enforcement precedent, and they're probably right. The longer it is not enforced, the less likely any President will enforce it." Editorial Board.

EDSALL: How Democrats can compete for the white working class. "On the surface, the Democratic Party's bid to win back the votes of the white working class looks like an impossible task. Between 2008 and 2012, President Obama's already weak support among these voters dropped from 40 percent to just 36 percent. Looked at from a different perspective, though, Democratic prospects do not seem so gloomy. There was a wide disparity in Obama's performance among white working-class voters in different sections of the country: awful in the South and significantly better in much of the rest of the country. This suggests that a targeted regional strategy could strengthen the Democratic Party's chances with what was once its core constituency." Thomas B. Edsall in The New York Times.

BLY: Climate talkathon would help if America were more scientifically literate. "As America becomes increasingly science-dependent -- the output of science affects us individually and nationally on a daily basis, and the complex nature of national and global concerns requires the tools and methods of science to navigate -- this stunning illiteracy threatens our national competitiveness, security, economy, and perhaps most alarmingly, the future of our democracy. And, this week, it renders America numb to the profoundly important arguments about climate change being advanced by our elected leaders. How can we pass and enact critical legislation based on scientific evidence when the vast majority of the country does not know what science is, how a scientific conclusion comes to be, or what it implies? Sadly, we probably can't. And to make matters worse, our scientific illiteracy renders us impressionable to misinformation about everything -- including climate change -- imbuing national conversations with deleterious counter-narratives (that appear "scientific" for strategic reasons). In the interest of our competitiveness, security, economy, and democracy, in the 21st century every single citizen of the United States of America should know what science is. All citizens should be able to apply the scientific method -- a majority of the country should have the propensity to do so -- and everyone should appreciate science's limits" Adam Bly in The Huffington Post.

Science interlude: The science of spiciness.

2. Intelligence agency outrage, take two

Feinstein: CIA searched intelligence committee computers. "A behind-the-scenes battle between the CIA and Congress erupted in public Tuesday as the head of the Senate Intelligence Committee accused the agency of breaking laws and breaching constitutional principles in an alleged effort to undermine the panel's multi-year investigation of a controversial interrogation program. Chairman Dianne Feinstein (D-Calif.) accused the CIA of -secretly removing documents, searching computers used by the committee and attempting to intimidate congressional investigators by requesting an FBI inquiry of their conduct -- charges that CIA Director John Brennan disputed within hours of her appearance on the Senate floor.'" Greg Miller, Ed O'Keefe and Adam Goldman in The Washington Post.

Explainers:

Is the CIA spying on congressional computers? Here's what you need to know. Andrea Peterson in The Washington Post.

Why the CIA and lawmakers are feuding. Adam Goldman in The Washington Post.

CIA feud with Senate panel puts lack of post-9/11 accountability in spotlight. Scott Wilson in The Washington Post.

CIA chief Brennan quickly fired back. "Mr. Brennan rejected statements made earlier Tuesday by Sen. Dianne Feinstein (D., Calif.) that the CIA inappropriately searched Senate computers. 'Nothing can be farther from the truth,' he told NBC's Andrea Mitchell in a forum at the Council on Foreign Relations on Tuesday morning. 'We wouldn't do that.' Mr. Brennan urged lawmakers to reserve judgment until investigations are complete and expressed confidence that the CIA would be absolved of any wrongdoing." Dion Nissenbaum in The Wall Street Journal.

Several lawmakers called for an independent investigation. "Many lawmakers on Capitol Hill reacted with outrage and said the CIA had compromised the oversight role of Congress. Some argued that the matter warrants a special investigative committee due to the complicated politics surrounding national security." Sabrina Siddiqui and Michael McAuliff in The Huffington Post.

Meanwhile, the long-beleaguered NSA seeks to rebuild public trust. "President Barack Obama's pick to lead the National Security Agency pledged on Tuesday to look for ways to build confidence in the beleaguered spy agency and, in a possible shift, stopped short of calling former contractor Edward Snowden a traitor. Vice Admiral Michael Rogers, now the Navy's top cyber warrior, was cautious during often terse exchanges at a Senate hearing on his confirmation to also lead the U.S. Cyber Command that saw critics and supporters prod him about the NSA's bulk collection of phone records, a program exposed by Snowden. Rogers spoke about the need for NSA transparency and accountability. But he did not signal a departure from the kinds of reforms already announced by President Barack Obama, including moving storage of telephone metadata - records of U.S. phone calls, their length and time - out of government hands." Patricia Zengerle and Phil Stewart in Reuters.

The military will soon have cyberattack capabilities, Rogers says. "All of the major combat commands in the United States military will soon have dedicated forces to conduct cyberattacks alongside their air, naval and ground capabilities, Vice Adm. Michael S. Rogers, President Obama's nominee to run the National Security Agency, told the Senate on Tuesday." David E. Sanger in The New York Times.

Long reads:

Snowden Inc. Josh Gerstein in Politico.

How a court secretly evolved, extending U.S. spies' reach. Charlie Savage and Laura Poitras in The New York Times.

Friendly reminder that your tweets are public interlude: Teachers read mean tweets by their students.

3. GM is being investigated from all directions

Justice Dept. is said to be investigating GM over delayed recall. "The U.S. Justice Department started a preliminary investigation into how General Motors Co. (GM) handled the recall of 1.6 million vehicles with faulty ignition switches linked to at least 13 deaths, said a person familiar with the probe. The inquiry is focusing on whether GM, the largest U.S. automaker, violated criminal or civil laws by failing to notify regulators in a timely fashion about the switch failures, said the person, who asked not to be named and isn't authorized to discuss investigations. GM shares fell the most in two years." Del Quentin Wilber, Jeff Plungis and Jeff Green in Bloomberg.

So are the Senate, the House, NHTSA and GM itself. "On Tuesday, Senator Jay Rockefeller, Democrat of West Virginia, said he would ask Senator Claire McCaskill, Democrat of Missouri, to hold hearings on a panel that oversees consumer product safety. The hearings are expected to begin within weeks. A House committee said on Monday that it would conduct its own investigation and hearings into events leading to G.M.'s recall of 1.6 million vehicles worldwide, and it sent letters demanding extensive records to the company and the National Highway Traffic Safety Administration. That agency is also investigating G.M.'s actions since the company first learned of possible defects in its ignition systems, in 2004. And G.M. has hired outside lawyers to lead its own review of why it failed to fix or replace switches tied to a mounting toll of fatal accidents. It is unclear whether any of the inquiries will lead to charges against G.M." Bill Vlasic and Ben Protess in The New York Times.

Transportation safety aside...chair of U.S. transportation safety watchdog to step down. "Deborah Hersman, the public face of the U.S. National Transportation Safety Board who fought last year to be nominated for another term as chairman, today said she's stepping down to head a safety-advocacy group....Hersman steps down as the board is still investigating the cause of battery fires in Boeing Co. 787 Dreamliner planes, last year's fatal Asiana Airlines (020560) crash in San Francisco and the deadliest accident in the history of Metro-North Railroad. The board is assisting in the investigation of a missing Malaysia Airlines plane that air-traffic controllers lost sight of on March 8 as it flew to Beijing from Kuala Lumpur....Obama nominated her for another term as chairman on Aug. 1, two days before her previous term was to end. As chairman, Hersman broadened the board's mission to transportation risks such as drunk and drugged driving and fatigue among pilots, truckers and train operators, rather than just responding to accidents." Angela Greiling Keane in Bloomberg.

Explainer: Questions and answers. Associated Press.

Iditarod interlude: A thrilling finish.

4. Democrats' populist economic push, cont'd.

Obama will seek broad expansion of overtime pay. "President Obama this week will seek to force American businesses to pay more overtime to millions of workers, the latest move by his administration to confront corporations that have had soaring profits even as wages have stagnated. On Thursday, the president will direct the Labor Department to revamp its regulations to require overtime pay for several million additional fast-food managers, loan officers, computer technicians and others whom many businesses currently classify as 'executive or professional' employees to avoid paying them overtime, according to White House officials briefed on the announcement....The overtime action by Mr. Obama is part of a broader election-year effort by the White House to try to convince voters that Democrats are looking out for the middle class. White House officials hope the focus on lifting workers' pay will translate into support for Democratic congressional candidates this fall." Michael D. Shear and Steven Greenhouse in The New York Times.

The backdrop: "Currently, many businesses aren't required to pay overtime to certain salaried workers if they earn more than $455 a week, a level that was set in 2004 and comes to roughly $24,000 a year. The White House is expected to direct the Labor Department to raise that salary threshold, though it is unclear by how much. Ross Eisenbrey, vice president of the liberal Economic Policy Institute, and Jared Bernstein, a former White House economist, recently proposed the limit be increased to $984 a week, or roughly $50,000 a year." Damian Paletta and Colleen McCain Nelson in The Wall Street Journal.

And Democrats are seeking to force an unemployment benefits vote in the House. "House Democrats are pulling out a now-familiar procedural trick - the discharge petition - to push for a floor vote on another one of their election-year priorities: Extending unemployment insurance. Lawmakers plan to file a discharge petition Wednesday that, if successful, would force a vote on extending jobless benefits until Jan. 1, 2015. The parliamentary gambit is almost certain to fail, considering Democrats would need GOP lawmakers to help them reach the threshold for 218 signatures and Republicans are loathe to endorse the effort. But using the discharge petition raises the profile of an issue that has been a top priority for Democrats, who have drawn on this procedural strategy for other hot-button issues such as raising the minimum wage. House Democrats are also expected to file a discharge petition soon on comprehensive immigration reform." Seung Min Kim in Politico.

Democrats' efforts come as economic pessimism drags Obama's approval rating to new low. "President Barack Obama is struggling to overcome widespread pessimism about the economy and deep frustration with Washington, notching the lowest job-approval ratings of his presidency in a new Wall Street Journal/NBC News poll. The results suggest Mr. Obama could weigh on fellow Democrats in midterm elections this fall, particularly in the conservative states that will play a large role in deciding whether his party retains its Senate majority. Mr. Obama's job approval ticked down to 41% in March from 43% in January, marking a new low. Some 54% disapproved of the job he is doing, matching a previous high from December, when the botched rollout of his signature health law played prominently in the news." Patrick O'Connor in The Wall Street Journal.

Explainer: Obama's technology push a double-edged sword for low-wage workers. Sudeep Reddy in The Wall Street Journal.

Animals interlude: Don't mess with this cat.

5. Is the end near for Fannie and Freddie?

Fannie Mae-Freddie Mac dismantlement plan is outlined by Sens. Tim Johnson, Mike Crapo. "The Senate banking committee's top leaders on Tuesday released the broad outlines of a plan that would dismantle mortgage giants Fannie Mae and Freddie Mac, advancing what many observers expect will be a multi-year effort to revamp the nation's housing finance system. For months, Sens. Tim Johnson (D-S.D.) and Mike Crapo (R-Idaho) have worked to hammer out a plan they could agree on and sell to their respective parties. In a joint statement, the lawmakers said they would unveil their legislation in 'the coming days.' But the bill is expected to face many hurdles, in part because leaders of both parties are not eager to take on a complex and politically fraught issue in the lead-up to this year's midterm elections. The legislation builds on a plan by Sens. Bob Corker (R-Tenn.) and Mark R. Warner (D-Va.) that would replace Fannie and Freddie with a new entity -- the Federal Mortgage Insurance Corp. -- and shift more of the risks of mortgage lending to the private sector." Dina ElBoghdady in The Washington Post.

And Wall St. was not amused. "Common shares of Fannie Mae and Freddie Mac experienced their biggest intraday drop in 10 months after leaders of the Senate Banking Committee announced plans to eliminate the companies in a new bill. Fannie Mae shares tumbled as much as 44 percent, paring the losses to 31 percent to close in New York at $4.03, after Edwin Groshans, a managing director at Washington-based equity research firm Height Analytics LLC, described the proposal as holder-negative. Freddie Mac fell 27 percent to close at $4.04. Preferred shares also dropped, some by as much as 12 percent." Clea Benson and Cheyenne Hopkins in Bloomberg.

@Phil_Mattingly: Wall Street freaks when senators do....exactly what they've said they were going to do for months.

But this thing is complicated and stands to get only more complicated. "The plan...has a lot of moving parts. At least three new entities would need to be formed. And no doubt it would get even more complicated if it moves through the legislative process." John Carney in The Wall Street Journal.

Explainer: The foreclosure crisis is still burning years after the housing crisis ended. Dina ElBoghdady in The Washington Post.

'Between Two Ferns' interlude: Director explains how Obama episode happened.

Wonkblog roundup

Japan's energy dilemma, in one chart. Christopher Ingraham.

Four reasons why the climate change fight is likely to fail. Steven Mufson.

Obamacare enrollment drops off in February. Jason Millman.

The foreclosure crisis is still burning years after the housing crisis ended. Dina ElBoghdady.

Facing Obamacare enrollment deadline, these states are pushing for more time. Jason Millman.

Congress to constituents: "Show me the money." Christopher Ingraham.

Et Cetera

Americans split on Obama's handling of Russia, Post-ABC poll finds. Peyton M. Craighill and Scott Clement in The Washington Post.

IMF funding issue delays Ukraine bill. Patricia Zengerle in Reuters.

Ohio looks at whether fracking led to 2 quakes. Henry Fountain in The New York Times.

U.S. calls on hospitals to improve disaster plans. Sheri Fink in The New York Times.

Clinton Keystone XL dodge prompts donors to rethink support. Jonathan Allen in Bloomberg.

Got tips, additions, or comments? E-mail us.

Wonkbook is produced with help from Michelle Williams.

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