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Obamacare: You still can't fix stupid...or make it pay

Today's news is filled with "he said/she said" type stories about how many Affordable Care Act enrollees have actually paid their first health-plan premium installments.


saverio Truglia | Photolibrary | Getty Images

A new report from the House Republicans says the number of non-payers is a stunning 33 percent. The administration has countered without any number of its own but it rightly says the GOP isn't using enough data. Thanks to the Health and Human Services policy not to release payment numbers promptly, the speculation will continue and it has no one to blame but itself.

No matter what the exact number is, there's no doubt the percentage of non-paying Obamacare enrollees will be much, much higher than anything private insurers have dealt with in the past. Default rates in that business usually run in the very low single digits. The kind of responsible and engaged people who got their own health insurance in the past tended to also be responsible enough to pay their bills on time. That's one of the things that made the health insurance self-coverage business so good for so long.

But no one should be surprised by what looks like a serious problem with payments under the ACA. Because the same force that stopped tens of millions of Americans from getting health-care coverage of any kind even before the ACA is still at work now … and you still can't fix stupid.

Read MoreObamacare: You can't fix stupid

All the cajoling, campaigning, and between-two-ferning by the Obama team did help get the total number of enrollees in the ACA somewhere near the officially reported number of 8 million.

But I don't remember seeing anything in those "get covered" ads that talked about how you have to pay for this coverage, certainly nothing about when the first bills were due.

Read MorePresident Obama gets between two ferns with Zach Galifianakis

All the people who talk about how hard it is to remove a government entitlement program once it's enacted are right, but what sets the ACA apart is that, unlike Social Security and Medicare, it requires its "beneficiaries" to send the government a check as opposed to just receiving one in the mail. That's a very big difference and it's already proving to be a potential Achilles heel for the entire program. This is like a self-repealing entitlement program the Republicans don't even need to get the votes for.

So, the predictable result will be that millions of these last-second enrollees will effectively drop out of the system relatively soon. People who never had insurance before and never had to pay these kinds of premiums are not the best people to target with the kind of "hard sell" the administration engaged in during February and March. It reminds me of those marketing campaigns they used to run at colleges where they gave incoming freshmen free sweatshirts and airline tickets in return for signing up for credit cards. A lot of the big banks stopped doing those campaigns when so many of the gullible students ran up credit card bills they couldn't pay. (25 years ago, I was one of those gullible students!).

With literally millions of traditionally non-engaged and responsible enrollees now in the system, my prediction is that more pain is on the way for the Obama administration and the private insurance companies who are still hoping the ACA will run smoothly and effectively.

Read MoreObamacare's latest tally: Almost 8.02 million

And all of this would be mildly amusing if it weren't for the fact that we're talking about health care here. If this keeps up, emergency rooms and doctors' offices are likely to become filled with more and more patients who wrongly think they're covered. Anger at the government is nothing new in America, but a focused and pointed anger over a specific domestic policy is rare and it's electoral poison.

Irresponsibility in our society is a serious problem, but the tricky thing about that is that it's an ill that can only be self-cured. If you're the kind of person who buys an iPhone and a 50-inch TV before getting some kind of health coverage for you and your family, it appears a very expensive and pushy national campaign can get some of you to sign up for the ACA, but darned if anyone can make you pay for it.

Commentary by Jake Novak, supervising producer of "Street Signs." Follow him on Twitter @jakejakeny.

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