With Enrollee Goal Met, Obamacare Still Faces Political Trial

Enlarge this image toggle caption Carolyn Kaster/AP Carolyn Kaster/AP

President Obama and his supporters had a rare opportunity to celebrate this week.

A last-minute surge in people signing up for health insurance sent the total government enrollment figures over the seven-million mark.

That number seemed out of reach just a few months ago, when a crash-prone website threatened to undermine the president's signature health care law.

Republicans are still bent on repealing the law, but now millions more Americans have a stake in Obamacare's survival.

It just takes a small number of people who view themselves as losers to make trouble for the law politically.

On Tuesday, the president marked the comeback. "The bottom line is this: Under this law, the share of Americans with insurance is up, and the growth of health care costs is down, and that's good for our middle-class and that's good for our fiscal future," he said.

We don't yet know how many of the new enrollees were previously uninsured, but multiple surveys show that overall insurance coverage is on the rise. Even before the surge in sign-ups over the last few weeks, Sharon Long of the Urban Institute estimated nearly 5.5 million people had gained coverage through private insurance or programs such as Medicaid.

"Insurance coverage is going up," Long says. "There may well be some people who've lost coverage. But the number of people who've gained coverage swamps that effect."

That doesn't mean the controversial health care law is out of the woods. Drew Altman, president and CEO of the Kaiser Family Foundation, says the real test is still to come, as people go to the doctor, make their co-pays, and decide whether the coverage is a good deal or not.

"When you look at the policies, there's no question but that the winners will vastly outnumber the losers," Altman says. "But we've also learned over the last year that it just takes a small number of people who view themselves as losers to make trouble for the law politically."

Indeed, Republican critics like Wyoming Sen. John Barasso continue to highlight the stories of people who've been hurt by the health care law.

"People paying more in premiums, people losing their doctors, not having access to the hospitals in their community, higher co-pay, higher deductibles," Barasso said. "That's what the American people are facing."

Republican Gov. Bobby Jindal of Louisiana offered his own, alternative health care plan this week, at a breakfast sponsored by the Christian Science Monitor. Jindal suggests offering vouchers as a substitute for Medicare and a tax break for those who buy health insurance on their own. He also wants to let the states decide how to protect people with pre-existing conditions.

"The Republican Party needs to be more than the party of no," Jindal said. "We have to have solutions. We talk about the need to repeal Obamacare and I think that's absolutely right."

But Democratic pollster Geoff Garin says repeal has just gotten more difficult. While polls show less than half the country approves of Obamacare, attitudes towards it have improved somewhat. Garin says we may have reached an "inflection point."

"I think the tables may have turned a little bit as more and more people feel they have a stake in the Affordable Care Act and who really don't want the Republicans to be taking away new rights and new benefits that they're enjoying because of the law."

Insurance companies will soon be deciding how much to charge for next year's coverage. The late surge in customers may help to limit price hikes, and perhaps boost competition. But there's likely to be wide variation around the country, and people in some areas may see much bigger increases than others.