Just one in four young Americans knows about Obamacare

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This Commonwealth Fund study should be very worrisome to supporters of President Barack Obama???s law: Just one in four 19- to 29-year-olds is even aware of Obamacare???s exchanges.

From October 2013 through March 2014, young adults without affordable health insurance through an employer will be able to select a plan from their state???s insurance marketplace, with coverage beginning January 2014. Those with incomes under 400 percent of poverty will be eligible for subsidized coverage or Medicaid. The survey findings demonstrate just how critical outreach and education will be to inform young adults about their new options. Only 27 percent of 19-to-29-year-olds in the survey were aware of the marketplaces, with awareness lowest among those uninsured for some time during the year (19%) and those in low-income households eligible for subsidized coverage or Medicaid (18%). Awareness also varied by education levels: one-third of college graduates were aware of the marketplaces, compared with 20 percent of those with a high school degree or less.

The chart is on page 6. There???s another aspect of the Commonwealth study that shows how one of Obamacare???s earliest policy announcements is working against the success of the law. As I noted on Twitter and Sarah Kliff writes about, a larger percentage of young Republicans than young Democrats are aware of Obamacare???s details, and particularly the provision allowing young people to stay on their parents??? insurance through age 26. This policy is now working against Obamacare???s overall success, since those lower-income Republican youngsters would be more likely to end up in Obamacare???s exchanges if they weren???t on their parents??? plan. Without them in the risk pool, we???re likely to see higher rate shock for those who do dive in.

The failure of Obama???s effort to promote his law to the generation that helped make him president is clear here, and part of the challenge for the administration is attempting to push these exchanges and subsidies to a population that is disengaged ??? and when they do engage, are likely to find Obamacare is not a good deal for them in the short or long run, as Chris Conover argues.

A recent study by the National Center for Public Policy Research shows that: About 3.7 million of those ages 18-34 will be at least $500 better off if they forgo insurance and pay the penalty. More than 3 million will be $1,000 better off if they go the same route.

Consequently, many more will opt to pay the extremely modest tax rather than fork over many thousands of dollars to purchase coverage that became substantially more expensive for young people thanks to the misguided pricing rules imposed by Obamacare. The risk that the law will fail in an ???adverse selection death spiral??? thus has gotten much larger. This claim is not in dispute. Instead, progressives argue it is too narrow.

More on this here. But while Obamacare is bad for the young in these measures, it???s great for Obama???s other constituency: Washington insiders and big money lobbyists.

As the clock ticks down to the launch of President Barack Obama???s healthcare reform, hundreds of businesses, unions and advocacy groups are still pushing to win concessions on the far-reaching law. Restaurants want to increase the number of hours that define a full-time worker. Unionized electrical workers are seeking to change the treatment of health plans offered by multiple employers. Medical device companies hope to end a tax against them even though they are already paying that tax.

Lobbyists face slim odds of getting any additional changes to the law before October 1, when millions of Americans will be able to sign up for subsidized health insurance through online exchanges in each state. But there is an urgency to push for changes now, legislative experts say, because it will become much harder to do so once the law takes full effect in January. Lobbying may also give these groups leverage in negotiations down the road ???

A Reuters review of lobbying records found that more than 500 companies, business groups, consumer advocates, unions and other organizations weighed in on the Affordable Care Act during the second quarter of this year.

The Washington lobbying windfall has been spectacular.

Major lobbying firms such as Fierce, Isakowitz & Blalock, The Glover Park Group, Alston & Bird, BGR Group and Akin Gump can all boast an Affordable Care Act insider on their lobbying roster ??? putting them in a prime position to land coveted clients ??? Veterans of the healthcare push are now lobbying for corporate giants such as Delta Air Lines, UPS, BP America and Coca-Cola, and for healthcare companies including GlaxoSmithKline, UnitedHealth Group and the Blue Cross Blue Shield Association.

Ultimately, the clients are after one thing: expert help in dealing with the most sweeping overhaul of the country???s healthcare system in decades …

The voracious need for lobbying help in dealing with ObamaCare has created a price premium for lobbyists who had first-hand experience in crafting or debating the law. Experts say that those able to fetch the highest salaries have come from the Department of Health and Human Services (HHS) or committees with oversight power over healthcare.

This is the Obama approach to governance: Pass burdensome regulations on everyone then dole out favors to your allies, as the powerful and wealthy work to exempt themselves from the rules.