In his latest column for the New York Times, Paul Krugman argues that Obamacare ultimately will work — and points to the California example as proof.
After conceding the rollout of Obamacare to have been "an epic disaster," Krugman insists that the question is not so much about whether Obamacare's start has been auspicious, but whether the disastrous unveiling is indicative of structural problems with the law, or if they were merely the consequence of bad management.
Looking to California, an extremely large state with a functional exchange market in which applications are surging, Krugman decides the answer is that bad management — not poor design — explains Obamacare's early travails. "What we have in California, then, is a proof of concept," Krugman writes. "Yes, Obamacare is workable — in fact, done right, it works just fine."
California is, however, an especially useful test case. First of all, it’s huge: if a system can work for 38 million people, it can work for America as a whole. Also, it’s hard to argue that California has had any special advantages other than that of having a government that actually wants to help the uninsured. When Massachusetts put Romneycare into effect, it already had a relatively low number of uninsured residents. California, however, came into health reform with 22 percent of its nonelderly population uninsured, compared with a national average of 18 percent.
Finally, the California authorities have been especially forthcoming with data tracking the progress of enrollment. And the numbers are increasingly encouraging.
For one thing, enrollment is surging. At this point, more than 10,000 applications are being completed per day, putting the state well on track to meet its overall targets for 2014 coverage. Just imagine, by the way, how different press coverage would be right now if Obama officials had produced a comparable success, and around 100,000 people a day were signing up nationwide.
Equally important is the information on who is enrolling. To work as planned, health reform has to produce a balanced risk pool — that is, it must sign up young, healthy Americans as well as their older, less healthy compatriots. And so far, so good: in October, 22.5 percent of California enrollees were between the ages of 18 and 34, slightly above that group’s share of the population.