The Streisand Effect and Obamacare

Despite the debacle of the Obamacare website at its unveiling and the earnest efforts of the Republican party to derail it (anti-Obamacare groups outspent those in favor by a ratio of 15 to 1), the New England Journal of Medicine reports that 20 million people have enrolled in the plan. (The full report can be seen here.) This graphic from the NEJM report shows the different ways that people can sign up.


They reached the 20 million total this way: 1 million adults under age 26 enrolled in their parents’ plan; 8 million enrolled in private coverage through the insurance marketplaces; 5 million enrolled in private coverage directly through their insurer; 6 million enrolled in Medicaid.

They also noted the disparity — and potential for even greater disparity — between the 28 states that expanded Medicaid under Obamacare, and the others that decided to not to following the 2012 Supreme Court decision.

“Those deciding not to expand Medicaid will benefit far less from the law, and since many of these states have high rates of uninsured residents and lower health status,” they said, “the ACA may have the paradoxical effect of increasing disparities across regions, even as it reduces disparities between previously insured and uninsured Americans as a whole.”

These results support other studies that show that the number of uninsured has plummeted since the introduction of Obamacare.

Niam Yaraghi at the Brookings Institution, after a state-by-state analysis, reports on what looks like a Streisand Effect.

In fact, after controlling for other state characteristics such as low per capita income population and average insurance premiums, I observe a positive association between the anti-ACA spending and ACA enrollment. This implies that anti-ACA ads may unintentionally increase the public awareness about the existence of a governmentally subsidized service and its benefits for the uninsured.

I still cannot wrap my mind around the fact that there were people who actively sought to discourage people from signing up for affordable health insurance and that there were others who actually took that advice.


  1. Marshall says

    The reason to me is undoubtedly that people, by and large, do not look into details themselves, and instead base their opinions on those whom they think have an understanding of the issue.

    A huge portion of the anti-Obamacare troupe gets their information from Fox News, corrupt politicians, and reporters/bloggers/writers who are so ideologically-driven that they purposefully warp facts and hide information in order to present Obamacare as something bad, because it means supporting the liberals.

    It’s similar to liberal boycotts of, say, Chick-fil-a, based on ideology (Chick fil-a was in the news for the strong anti-gay stance of its leadership), even if they offered the most affordable chicken. Of course, to take the analogy further, we liberals would have had to go around parading that their chicken was more expensive than other competitors. (Note: I know nothing about prices, I’m just making this up for the analogy.)

  2. Marshall says

    By the way, I’d like to add that even I do not really know what Obamacare did with respect to insurance. I’ve read it a few times, but I always forget about 10 minutes later, mostly because I’m pretty uninformed in general about the ins and outs of health insurance, which is a subject I’ve found to be fairly complicated. If I, a person who highly vlaues truthful information, don’t understand it, I certainly don’t expect the Republican mudslingers to understand it.

  3. astrosmash says

    The way it’s gonna play out is that in the red state republican primaries one of the contenders will run on advancing the ACA (while still bashing democrats of course) and win. Iv’e said it before, many people in the non-participating states ceratinly have relatives in participating states who are now insured. The fact that someone els has access to healthcare tha you dan’t AND the fact that you’re still paying whatever minimal federal taxes go for supporting the ACA is gonna drive folks nuts.

  4. Mano Singham says


    I agree. In Canada, single payer began in one province and spread to others as the advantages began to be more widely realized. What is even more interesting is what will happen with Vermont’s single-payer system when it gets operational.

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