EDITORIAL: Obamacare’s stagnant enrollment shows need for new ideas

The Affordable Care Act was supposed to improve the quality of health insurance and make coverage more affordable, as well. The uninsured were supposed to flock to insurance exchanges, as were millions who were already covered.

So why are millions of uninsured Americans still rejecting Obamacare? Because the Affordable Care Act is not all that affordable after all.

As reported by the Cato Institute, the Department of Health and Human Services projects enrollment through the exchanges that offer federal subsidies will be far below Congressional Budget Office estimates for the second year in a row. The CBO had forecast that enrollment would reach 21 million in 2016, but HHS says "a strong and realistic goal" is in the neighborhood of 10 million — a mere 900,000 more than the department's estimate for this year's signups.

While enrollment is stagnating, however, the costs associated with Obamacare keep going up. Premiums are rising, deductibles are rising even faster to keep premiums from rising more, and the tax penalty for not having health insurance is going up, too.

HHS Secretary Sylvia Burwell says those who are still uninsured "have a lot of concerns about whether or not they can afford coverage." She says "almost 60 percent are either confused about how the premium tax credits work or don't know that they are available." She says HHS is going to "work smarter" to reach these people.

But Joe Rago of the Wall Street Journal editorial board sees through that spin. He says people generally aren't signing up for Obamacare unless they get a sizable subsidy. This makes the coverage essentially free to them (at everyone else's expense). But as the subsidies are phased out, these recipients have to pay more out of pocket. And the vast majority of those on the margin and in the middle class simply can't make it work with their budgets.

The bottom line? People won't buy lousy, overpriced health insurance if they can't afford it. And the longer the enrollment numbers stay low, the less viable the plans are because the risk is spread across fewer people. As a result, there are already calls among Democrats and other Obamacare proponents for the federal government to be more aggressive with individual mandate penalties and essentially force more people into the program.

American voters are now less likely than ever to believe that Obamacare is (or will ever be) just swell, and they would be more than happy to hear candidates' proposals to roll back or replace the legislation. Presidential and congressional candidates should hit the campaign trail armed with ideas, such as reduced coverage mandates, an end to the tax penalties and market-based reforms that emphasize incentives over coercion. Obamacare is very much a campaign issue yet again.