Two years later, the Kaiser Family Foundation has issued a report that suggests these warnings were more accurate than the upbeat predictions of Covered California Executive Director Peter Lee. A key finding:

“Among adults who say that they pay a monthly premium for their health coverage, nearly half of newly insured adults (47 percent) say it is somewhat or very difficult to afford this cost, compared to just 27 percent of adults who were insured before 2014. When looking specifically by type of coverage, 44 percent of Covered California enrollees (not all of whom are newly insured) report difficulty paying their monthly premium, versus a quarter of adults with other types of private coverage. Medi-Cal enrollees do not pay monthly premiums for their coverage.”

Cost, not glitches, slowing CA sign-ups

The Kaiser report, which was based on interviews with 4,555 Californians, says the cost factor is the biggest barrier to higher enrollments, not online technical snafus:

“Cost continues to prevent many uninsured adults from seeking coverage. While many people focused on website glitches and administrative barriers during 2014, uninsured adults say that the reason they still lack coverage is because it’s too expensive, with most not even trying to get ACA coverage, and many who did still saying they are ineligible or believe the coverage is too costly.”

The cost of premiums is also prompting Californians to quit Covered California, KCRA TV in Sacramento reported, citing documents showing that 150,000 people dropped their state coverage in 2014.

These developments come in a pivotal year for Covered California — the last year in which federal subsidies will help cover the subsidies provided by the state agency. By law, beginning in 2016, the agency cannot seek state subsidies and must rely only on revenue it generates from premiums. Its goal was to have 1.7 million residents enrolled by Feb. 15, but it fell far short, with 1.4 million signups.

More criticism from national media

Meanwhile, Covered California is again provoking comment from outside of California. A May 31 Columbia Journalism Review essay by Trudy Lieberman criticized coverage of the agency as misleading:

It’s not easy to figure out how to monitor the progress of Covered California, the country’s largest state-run health insurance exchange.

 

Is it the total number of people who have signed up for an insurance plan on the exchange during open enrollment? The rate at which people renew? The number of new sign-ups in a given year? The number of Latino sign-ups? The number of “covered lives”? The number of Californians who have had coverage through the exchange at any point? Or, simply, the overall rate of uninsured adults across the state?

 

“In recent months, Covered California has cited each of these measures to tout its success. And though outside analysts have raised some notes of caution, press coverage has largely followed the lead set by the exchange. The result is coverage that has too often been reactive, short on enterprise, and with missed opportunities to ask some necessary questions. Covered California may ultimately have a success story to tell — but it will need to face some sharper skepticism before we can be sure.”

Lieberman wrote that California journalists should spend more time talking to affected state residents about their experiences with the agency and be less inclined to accept Covered California’s characterizations of its record.

But in California, Covered California enjoyed the usual upbeat happy talk in its media coverage. The San Francisco Chronicle is a good example:

“A last-minute surge of Californians trying to sign up for health insurance before Monday’s midnight deadline slowed down the state’s enrollment website and lengthened wait times for people who called the agency’s toll-free number for help.

“More than 155,000 people signed up for coverage under the Affordable Care Act from March 24 through 2 a.m. Monday, pushing total enrollment in the state health exchange past 1.2 million Californians.”

In the Chronicle’s lengthy article, it never even mentioned such basic distinctions as how many people had paid their premiums versus merely “enrolling.” Nor did it try to determine how many of the sign-ups would be subsidized by taxpayers and how many were paying full price. This angle is absolutely crucial to the long-term viability of Covered California.

Why isn’t this stuff covered? My assumption after 24 years as a California journalist is that it’s a mix of bias, peer pressure and incompetence.

ACA mostly insuring the previously insured

For properly skeptical coverage of the Affordable Care Act, nobody’s done better than former Wall Street analyst Avik Roy. Here’s  part of what he posted Monday on Forbes.com:

“Today is March 31, 2014: in theory, the last day you can sign up for coverage under the subsidized Obamacare insurance exchanges. If you’ve been a regular reader of this space, you know that the numbers routinely paraded by the Obama administration regarding Obamacare website sign-ups don’t tell us much about the actual number of uninsured individuals who have gained coverage. A new study from the RAND Corporation indicates that only one-third of exchange sign-ups were previously uninsured. …

“The RAND report appears to corroborate the work of other surveys. Earlier this month, McKinsey reported that 27 percent of those signing up for coverage on the individual market were previously uninsured.

“One important finding of the McKinsey survey was that the proportion of those who had formally enrolled in coverage, by paying their first month’s premium, was considerably lower among the previously uninsured, relative to the previously insured. 86 percent of those who were previously insured who had ‘selected a marketplace plan’ on the exchanges had paid, whereas only 53 percent of the previously uninsured had. …

“What’s important to remember is that this is not how Obamacare was supposed to work. The Congressional Budget Office, in its original estimates, predicted that the vast majority of the people eligible for subsidies on the exchanges would be previously uninsured individuals.

“Instead, the vast majority are previously insured people, many of whom are getting a better deal on the exchanges because they either qualify for subsidies, or because they’re older individuals who benefit from the law’s steep rate hikes on the young.”

So while we don’t know what’s going on in California, nationally, the overwhelming number of people who are actually paid enrollees in the federal exchanges are people who had to get new policies because of Obamacare — not people who were previously uninsured.

You know, the folks who are the core central focus of Obamacare.

Maybe eventually the San Francisco Chronicle will get around to reporting on this angle in California.

By Chris Reed

Last week, when the California agency that has the lead role in implementing Obamacare announced the rate structure for various insurance plans to be offered beginning Jan. 1, 2014, the media jumped to a lot of conclusions — conclusions flattering to Obamacare, as one would expect from a media that mostly waited until after the health care overhaul was adopted to point out its many immense flaws. (The New York Times put out a devastating analysis — but it was three weeks after Obamacare was signed into law!)

On California’s version of Obamacare, here was what the Los Angeles Times emphasized early in its story:

“‘These rates are way below the worst-case gloom-and-doom scenarios we have heard,’ said Peter Lee, executive director of Covered California, the state agency implementing the healthcare law.”

Here was what The New York Times’ Paul Krugman emphasized:

” … important new evidence — especially from California, the law’s most important test case — suggests that the real Obamacare shock will be one of unexpected success. … the California bids are in — that is, insurers have submitted the prices at which they are willing to offer coverage on the state’s newly created Obamacare exchange. And the prices, it turns out, are surprisingly low. A handful of healthy people may find themselves paying more for coverage, but it looks as if Obamacare’s first year in California is going to be an overwhelmingly positive experience.”

LAT and Krugman: What they didn’t mention

Not so fast, say two journalists who have written extensively about Obamacare, and not from inside the tank that houses the mainstream media.

This is from Avik Roy of Forbes:

“If you’re a 25 year old male non-smoker, buying insurance for yourself, the cheapest plan on Obamacare’s exchanges is the catastrophic plan, which costs an average of $184 a month. (That’s the median monthly premium across California’s 19 insurance rating regions.)

“The next cheapest plan, the ‘bronze’ comprehensive plan, costs $205 a month. But in 2013, on eHealthInsurance.com (NASDAQ:EHTH), the average cost of the five cheapest plans was only $92. In other words, for the average 25-year-old male non-smoking Californian, Obamacare will drive premiums up by between 100 and 123 percent.

“Under Obamacare, only people under the age of 30 can participate in the slightly cheaper catastrophic plan. So if you’re 40, your cheapest option is the bronze plan. In California, the median price of a bronze plan for a 40-year-old male non-smoker will be $261. But on eHealthInsurance, the average cost of the five cheapest plans was $121. That is, Obamacare will increase individual-market premiums by an average of 116 percent.

“For both 25-year-olds and 40-year-olds, then, Californians under Obamacare who buy insurance for themselves will see their insurance premiums double.”

This is from Peter Suderman of Reason:

“… this good news is not as good as it might sound, because it’s based on a misleading comparison: next year’s individual market rates with this year’s small-employer plans. A more useful comparison would be with this year’s individual-market premiums. And what that comparison reveals is that rate shock is real, and that the hikes are far larger than the comparison with small-group rates would suggest.”

Karma time: Bay Area to be hardest hit

The good news here is that as much as the media has been cheerleading for Obamacare, it remains highly unpopular — even before it kicks in. When people actually have to pay much more for insurance than they used to, the backlash is likely to reach a whole new level.

And here in California, the hardest-hit will be Obama’s biggest fans. Karma, baby! Avik Roy of Forbes says Obamacare’s impact on premiums for 40-year-olds “is steepest in the San Francisco Bay area, especially in the counties north of San Francisco, like Marin, Napa, and Sonoma.”

More from Roy:

“Supporters of Obamacare justified passage of the law because one insurer in California [Anthem Blue Cross] raised rates on some people by as much as 39 percent. But Obamacare itself more than doubles the cost of insurance on the individual market. I can understand why Democrats in California would want to mislead the public on this point. But journalists have a professional responsibility to check out the facts for themselves.”

If only California journalists lived up to that professional responsibility.