Obamacare Sign-Ups Beat January Enrollment Projections, But Total Enrollment Still Falls Short

Whitehouse.govWhitehouse.govObamacare supporters seemed rather pleased with yesterday’s enrollment figures. More than 1.1 million people signed up for private plans in January, making it the first month to beat early enrollment projections.

According to administration figures, 1.14 million people signed up for private health plans through the law's exchanges last month, a little more than the 1.059 million that had been projected.

But overall sign-up totals for private insurance, which now stand at 3.3 million nationwide, still lag behind early enrollment projections by about 1.1 million.

Even with January’s above-target sign-up count, it’s still going to be quite difficult for the administration to meet its initial enrollment target of 7 million people by the end of open enrollment in March. In order to hit that target, the administration would need to get more people to enroll over the next two months than signed up in the first four months.

Enrollment is already slowing dramatically from its December peak. January sign-ups were above target for the first month of the year, but still down by about 49 percent from December. That pace probably won’t pick up significantly in February, which means that whatever enrollment surge we see in March (the final month for 2014 enrollment) will have to be quite large.

All this assumes that basically all of the "sign-ups" the administration is reporting eventually convert into paid enrollments. But that seems unlikely. Because most exchanges aren’t handling or tracking premium payments themselves yet, it’s hard to get a complete picture of how many people have paid their first premium, which is necessary for enrollment. But insurance industry officials and well-connected sources say that only about 70-80 percent of sign-ups have actually paid so far. And in Washington state, which is tracking payment rates, only about half of sign-ups have resulted in payment so far.

The health law’s supporters have taken to arguing that total enrollment matters less than the demographic mix. (Insurance pools need a significant proportion of younger, healthier individuals to balance out the higher health costs of older and sicker enrollees.) But the administration’s early targets look increasingly difficult to meet there as well. The goal had been for about 39 percent of sign-ups to be between the ages of 18 to 34. The latest figures show that just 25 percent of sign ups so far fall in that age cohort.

The administration and insurers have marketing campaigns in the works. But they seem to be about as well planned as the rest of Obamacare’s rollout. Early plans for door-to-door outreach were scrapped, and Obamacare’s enrollment website is scheduled to be down on National Youth Enrollment Day.

Still, because of the geographic segmentation of the insurance market, a simple binary success or failure metric doesn’t fully capture the law’s results. There are 50 different states, with 50 different insurance markets, and it’s already clear that there’s going to be a lot of variance. Philip Klein of The Washington Examiner compared yesterday’s sign-up figures with projected enrollment totals in each state, and found that 11 were beating their sign-up estimates. But 12 states and the District of Columbia had come in at less than 50 percent of their targets.

So at this point it looks like Obamacare will continue to limp forward. As Avik Roy argues at Forbes, the sign-up numbers now suggest that although it will likely be more expensive and less successful than advertised, it won’t simply collapse. Obamacare continues to prove not so much that it can work, but that it can survive.

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  • Palin's Buttplug||

    So about 1% of the US populace has signed up and only about 1/2 that number have been materially effected by the law.

    What a waste of time this whole thing has been. And for those predicting electoral disaster - too bad. You will be wrong again.

  • R C Dean||

    Yes, nothing like the comprehensive, end-to-end failure of a massive government program to insulate the party that passed it from electoral disaster.

    The number affected by OCare so far is much higher than the number who have signed up. Let's not forget the 4 - 6mm who had their policies cancelled.

    And, let's not forget that cancellation notices will start rolling out for the large (100+ employers) around October 1 (for the states that require 90 days notice) with another wave on November 1 (for the states that require 60 days).

    Yeah, the Dems have nothing to worry about.

  • tarran||

    Why are you interacting with it as if it's people?

    It's an insane drunken incontinent wretch. Ignore it. By giving it negative attention you are rewarding it and encouraging it.

  • R C Dean||

    tarran, my rule is to refute it with a single post, but not engage it any further.

  • ||

    Why feed it at all? What is the point? It's not even a real person anyway, so what do you gain by interacting with a sockpuppet? You need to think, man.

  • R C Dean||

    Think?! This is the internet, man! There's no thinking on the internet!

  • ||

    You clearly have no idea how electoral politics works if you think this won't swing the election.

  • Palin's Buttplug||

    It didn't in 2012. In fact the Dems gained Senate seats.

    2014 is a problem for the Dems in that it is a midterm with lots of purple states up for grabs. Put Hil-Dog at the top of the ticket in 2014 and the ACA would mean next to nothing.

    The Dems are already guaranteed to lose three Senate seats anyway.

  • ||

    ??? It wasn't an election issue in 2012 because the GOP ran Mittens, the only candidate incapable of making it an issue.

  • Whahappan?||

    Also, it hadn't been implemented yet, it was all promises and rosy projections at that point. Now the real world consequences are becoming apparent, and the more those are felt the worse it will get.

  • Sevo||

    Palin's Buttplug|2.13.14 @ 12:50PM|# ..."about 1/2 that number have been materially effected by the law."

    You slimy turd, YOU go get insurance for the people who got booted if you want t0 trivialize it.

  • Jordan||

    about 1/2 that number have been materially effected by the law.

    So I can forgo purchasing health insurance?

  • OldMexican||

    Re: Palin's Buttwipe,

    So about 1% of the US populace has signed up and only about 1/2 that number have been materially effected [sic] by the law.


    Incorrect. The whole current population of the US are materially-affected by this law.

    Don't believe me? Remember the mandates? Remember the tax increases? The FSA cap of $2,500 only? They all affect everyone, materially. So your contention is completely wrong.

    And for those predicting electoral disaster - too bad. You will be wrong again.


    Are you implying that those incumbent Democratic senators and legislators are being irrational by running away from Obamacare and the president, or having psychotic episodes?

  • pan fried wylie||

    current population

    What are the dead, chopped liver? Think of all those corpses who aren't materially affected, smartguy.

    /declaresvictory

  • Jordan||

    Only the dead have seen the end of Obamacare.

  • XM||

    "So about 1% of the US populace has signed up and only about 1/2 that number have been materially effected by the law."

    But that means people aren't enrolling in ACA.

    Is that the new standard of success of ACA? "The embarrassingly low enrollment figures prove that ACA isn't the national disaster predicted by their foes"?

    Lots of people can qualify for medicaid, meaning they won't pay a diddily cent in to the insurance pool.

  • R C Dean||

    The latest figures show that just 25 percent of sign ups so far fall in that age cohort.

    And we don't know how many of those will actually pay the premium and get insured, so the number is lower than that. That young cohort is likely to have a proportionally higher non-payment rate, poisoning the pool even more.

    That reminds me: the notices of rate increases for the HIE plans will also start rolling out late this year, likely before the election in many states.

  • Drake||

    Yep - signing up is the easy part, even on the worst website of the 21st Century.

    Actually writing the checks... I would be surprised if half of them actually follow-through and pay.

  • Invisible Finger||

    Maybe this is BHO's backdoor way of forcing people into government labo-, er, service camps.

  • LiveFreeOrDOH!||

    And there will lie the truth. I wonder if it is like eBay where you can give them bad feedback for not paying.

  • pan fried wylie||

    The only pre-existing condition legally justifying applicant rejection.

  • SugarFree||

    That reminds me: the notices of rate increases for the HIE plans will also start rolling out late this year, likely before the election in many states.

    Unless Obama gets out his magic pen and delays them.

  • R C Dean||

    Those are state law requirements. Obama will be hard-pressed to negate state insurance regulation.

  • Invisible Finger||

    If they really wanted to get the under-35 crowd to sign up, they would have made an iphone app and have it take the monthly premiums from their itunes account.

    But then Apple would have to get a third of the revenue. But it would be totally worth it because Apple could then pay a living wage.

  • pan fried wylie||

    to a Chinese worker. so, win-win.

    /progderp

  • JWatts||

    Well since this happened:

    "and Obamacare’s enrollment website is scheduled to be down on National Youth Enrollment Day."

    I'm going to go with the Administration is completely incompetent theory.

  • JWatts||

    Wait that should be:

    "the Administration is completely incompetent hypothesis"

    There's still a few years for them to prove it wrong. ;)

  • R C Dean||

    the sign-up numbers now suggest that although it will likely be more expensive and less successful than advertised, it won’t simply collapse.

    Not right away. The death spiral doesn't start the first year, but the second, when premiums adjust to reflect the higher risk of the toxic pool.

  • Sevo||

    Pretty sure the arithmetic is as follows:
    "About 48.6 million people were uninsured last year, [2011]"
    http://www.bloomberg.com/news/.....-says.html
    The government admits that 5.5M people have lost insurance, so that's 54M people without insurance.
    And this wonderful program which is to make everybody healthy, wealthy and wise has 'signed up' (whatever that means)
    (drumroll!)
    3.3M!

  • Agammamon||

    But that's 3.3 million who now have 'real insurance'. That 5.5 million was full of people without 'real insurance' who just hated their plans.

    So its a net gain, not loss.

  • UnCivilServant||

    Do these numbers also include the 2million who "obviously didn't like their jobs"?

  • Agammamon||

    That's a whole separate accounting.

    The 2 million difference are the people who 'didn't like their jobs' got laid off and now can't afford *any* health insurance, even with the subsidies.

    So, like, *everybody* is better off.

    3.3 million got rid of their 'bad insurance' and another 2ish million left their job that they didn't really want in the first place.

    See how the Democrats have improved things for everyone.

  • Brett L||

    I love this: "I think the Titanic will sink much more slowly if we arrange the deck-chairs like so."

    The only thing that has happened in a gigantic Medicaid expansion -- much of which is coming in those states that took the Federal money. What is Illinois or California going to do when every jail follows Cook County in signing up every inmate for Medicaid? There's a 10 year phaseout on funding back to the original state-federal match funding. People are insane if they think anyone but the insurance companies and CMS service providers are winning here. I'm not even sure about those parties. But the 4th income quintile is not suddenly going to be saved from medical bankruptcies. This is madness.

  • pan fried wylie||

    the administration would need to get more people to enroll over the next two months than signed up in the first four months

    To be fair, the procrastination curve supports such a possibility.

  • pan fried wylie||

    procrastination curve: the exponential relationship between the time until a deadline and the number of people acting on the deadline.

  • Agammamon||

    Yeah, look at the percentage of people who mail off their tax return on the afternoon of Apr 15th.

  • JWatts||

    Yes, but a good chunk of those people owe money.

  • R C Dean||

    Health insurance sign-up looks like an upside down bell curve. There's a spike when enrollment opens, a lull, then a spike when enrollment closes.

    So, sure, there will be a rush at the deadline. Highly unlikely there will be enough of a rush to close the gap.

  • pan fried wylie||

    I contend that the closing spike is at least an order of magnitude larger.

    Great, now I'm gonna have to find the numbers and put them in excel.

  • R C Dean||

    Its typically bigger, but not that much bigger.

    With a rollout as horrible as this, though, the early spike may have been suppressed. But those folks are likely the ones who signed up in January.

  • JWatts||

    Th numbers I've heard on similar policies is roughly 40/20/40. That's 40% in the first period, 20 percent in the middle period and 40% in the last period.

    So one would expect to see roughly as many people sign up in February and March as signed up in October and November. Except that the fracked up website screwed up October enrollment. So nobody really knows.

  • Agammamon||

    You know what's scary? In a couple of years this program is going to collapse under its own weight. Have we ever had a massive entitlement program do that? Millions of people kicked off the government teat all at once.

    We can't reform SS because of that fear, but at least SS isn't going to fall completely apart in the immediate future. PPACA will have a hard time making it to the end of the next president's term.

    Maybe the Democrats are planning on throwing the next pres election, so when this falls apart they can blame it on a Republican.

  • Drake||

    They are doing a great job of throwing the next Congressional election.

  • Palin's Buttplug||

    You're wrong because the ACA is not a discrete program.

    If you were to say the ACA would make Medicaid fall apart then you would have an argument.

    The heart of the ACA is an eInsurance type marketplace where private companies suppliers.

  • LiveFreeOrDOH!||

    There is this side of the story too: http://www.nationaljournal.com.....s-20131110 If/When it will collapse, the insurance companies will be protected thanks to the "Risk Corridors" with taxpayers and businesses footing the bill. Get your popcorn (and your wallets).

  • db||

    What. The. FUCK. Is "National Youth Enrollment Day?"

  • UnCivilServant||

    Comrade, it is when the newly young comrades join the party. Your ignorance of it says you might need re-illumination...

  • Drake||

    Like a Nuremberg Rally but with less style and efficiency.

  • Swiss Servator, Befehl!||

    Instead of brownshirts with torches and standards, it is rows of Pajama Boys holding up their illuminated iPhone 5s?

  • Gilbert Martin||

    "The health law’s supporters have taken to arguing that total enrollment matters less than the demographic mix. (Insurance pools need a significant proportion of younger, healthier individuals to balance out the higher health costs of older and sicker enrollees.) "

    To the Obamacare supporters, the goalposts are always on roller skates.

  • Invisible Finger||

    I thought the President cancelled the law.

  • The Late P Brooks||

    Where are the young healthy and dumb when you need them?

    On the other hand, not enough of these new customers are young and healthy, and it's unclear how many of those gaining coverage didn’t have it before.

    Why does this matter? Because younger enrollees are cheaper, and they help balance the risk pool. One-quarter of new enrollees are ages 18 to 34, below the 40 percent threshold the administration at first said was necessary to keep premiums steady. Moreover, 55 percent of enrollees are women, who are generally more expensive to insure than men, mostly because of maternity care.

    The only debate worth having is how to improve enrollment. If not enough people sign up, or the mix of beneficiaries isn’t quite right, it could lead to higher premiums down the road, pushing people away from buying coverage and making the law less effective.

    In other words, what matters now is how to persuade more young people, especially young men, to sign up for health insurance before March 31. What has the administration learned in the first fourth months of open enrollment? What works and what doesn't? Everything else is beside the point.

    Help! Our pyramid scheme is upside down!

  • Swiss Servator, Befehl!||

    +1 iznoP emehcs

  • JWatts||

    "Where are the young healthy and dumb when you need them?"

    Oddly enough, they're broke, but they do have a bitchin new phone.

  • Grand Moff Serious Man||

    I normally find progressive gloating insufferable, but to see the people at HuffPo, Salon, Raw Story and other sites celebrate this news is just flat out hilarious.

    Do they really have no idea or deep down do they know how fucked they are for supporting this and are just in denial?

  • UnCivilServant||

    The dissonance filters in their brains might be running hot, but they're still compensating.

  • Sevo||

    "Do they really have no idea or deep down do they know how fucked they are for supporting this and are just in denial?"

    Look no further than the first post in the thread.
    The new talking points have been issued; the boot-lickers have been briefed and none shall say a bad word about it!
    Failure = success!

  • Brett L||

    I think they don't know. One of the things I will say for medical marijuana is that it allowed people who had previously opposed drug legalization a way of re-examining their beliefs without having to be completely wrong in their former belief. Same thing with civil unions for gays. My parents, being boomers and not particularly religious Republicans used to oppose and have moved thoroughly to apathetic on these issues, and I think that is happening across wide swathes of the population.

  • Invisible Finger||

    without having to be completely wrong in their former belief.

    But their former belief IS completely wrong (and they still believe it so it really isn't former, it's now "nuanced" - which is short for doublethink).

    Why enable and encourage such lunacy?

  • JWatts||

    Confusing nuanced with doublethink is pretty ridiculous.

    And this approach:

    "Why enable and encourage such lunacy?"

    is not going to move people in the direction your advocating.

    *****

    Right Winger: Well, I don't really think God literally created the Earth in seven days, but I do think he kicked off the Big Bang.

    Invisible Finger: You're a lunatic.

    Invisible Finger: And why don't you vote for a more Libertarian candidate next election?

    Right Winger: Umm, because Libertarian's are fucking assholes.

  • Homple||

    Success should be measured by counting the number of regulatory diktats issued by the new agencies created by Obamacare. That is the true measure of what the act was intended to accomplish.

  • Invisible Finger||

    "How am I going to pay off my student loans with insurance premiums this high??"

  • Sevo||

    We have an app for that.

  • Fluffy||

    My experience with the Vermont site leads me to conclude that they're lying about the signups to deliberately deceive the public.

    Possibly people managing the exchanges are lying about the signups to deceive their superiors. It's hard to tell from the outside.

    I filled out an application for the sole purpose of seeing the prices. I never selected a plan. I never bought anything.

    About a month ago I got a letter, addressed to my son, welcoming him to a new insurance plan and giving him a membership card.

    I called the exchange and pointed out that I had never chosen any plan, either for myself or my son. They cancelled his membership in that plan and sent me a cancellation notice.

    Last week I got a DIFFERENT letter for a DIFFERENT plan, again welcoming my son and giving him a membership card. So I had to call AGAIN.

    I have no doubt both of those "signups" were included in the "signup total".

    As soon as they started counting signups where no premium had been paid, you knew that the bullshit fix was in. They are simply throwing people into plans and declaring them "signed up". They're doing so for the sole purpose of bulking up the signup number. There's no way this is just a mistake; no way it's simple incompetence. No database designer is that incompetent. They know I never signed up for anything, and they don't care.

  • ||

    Sounds pretty par for the course for government, especially (and I'm being redundant here) a totally clusterfucked government project.

    Lying is a way of life for them. Why wouldn't they if they never get called on it? Who is going to punish them?

  • Tman||

    What is most telling is what they DON'T say, such as how many people have actually PAID for these services so far.

    We all can see that whenever they have something that resembles good news about the program they shout it from the rooftops.

    If they had even a sliver of proof that even half of the supposed 3 million that signed up had paid for it already they would also be shouting it from the rooftops, but they are not so QED.

    The other sparsely mentioned fact is that something like 80% of the sign ups have received subsidies. Holy shit that is fucking terrible for the death spiral.

  • Lost_In_Translation||

    Its Medicaid part E

  • Lost_In_Translation||

    Sounds to me like you signed up twice and going on a third.

  • creech||

    It will be interesting, too, a year or so from now when some younger person says "You know, I didn't use my insurance once." and the friend replies, "Chump; the penalty tax is a lot less than you paid in premiums. Maybe you should just stop paying for insurance? And if something really bad happens, they can't deny you coverage."

  • Invisible Finger||

    they can't deny you coverage

    Another government statement one should believe at their peril.

  • Spoonman.||

    Forget enrollment, the restrictions on what doctors you can use and where are going to become more and more evident, which will affect nearly everyone.

  • Invisible Finger||

    Imagine health care like the DMV.

    Before one postss about how the DMV isn't that bad, stop and think about the lowered expectations. When I get my license renewed, I have to go to FIVE different stations in the DMV facility. This could easily be TWO stations, one for the exam and picture, one for the cashier and be performed in less than half the time. A 30 minute trip to the DMV could be done in 10 minutes.

    So a 3-hour visit to the emergency room will be 9 hours minimum. The only good news is more people should bleed out by then.

  • Lord Humungus||

    Or from a macro view: even if Obamacare does meet the projected enrollment numbers, it's still a POS law with plenty of bad side-effects.

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