Obamacare

Obamacare "Enrollment" Totals Don't Tell Us How Many People Have Actually Enrolled

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Healthcare.gov

After weeks of refusing to reveal health plan enrollment totals through the health insurance exchanges launched in October, federal officials released Obamacare "enrollment" numbers for the first time this afternoon. Except that they aren't real enrollment numbers.

According to the release, 106,185 people have "enrolled and selected a Marketplace plan" from either a state-run exchange or the federally facilitated exchange system operating in 36 states.

The important words to notice in that sentence are "and selected."

As a companion report on exchange activity by an office within the Department of Health and Human Service explains, the 106,185 figure represents the number of "plan-eligible persons" who "have already selected a plan by clicking a button on the website page." 

That's really just an awkward way of saying that the report counts all the people who have done the equivalent of moving a plan into their online shopping carts—regardless of whether or not they have actually paid their first month's premium yet. Given that those who don't pay won't be covered, this means that the true enrollment number so far is almost certainly significantly lower.

The report does provide a sense of how much the federal exchange network has struggled. Of the 106k plan selections, just 26,794, or about 25 percent, came through the federal exchange system, which includes Florida and Texas, two key large states where the administration has indicated that enrollment is critical to the law's success.

The report's state-by-state breakdown of plan-selection totals also offers some hints about the difference between the number of people who have taken the step of "clicking a button on the website page" and the number of people who have fully enrolled. For example, the HHS report lists 97 people as having selected a plan in the state of Delaware, one of the 36 states relying on a federal exchange, between October 1 and November 2. But the Associated Press reported last week that Delaware's federally funded marketplace guides have successfully managed just four total enrollments in the state.

Even the "selection" number doesn't bode well for the law's success at getting people covered. Before the launch of the exchanges, administration officials expected that about 500,000 people would enroll in private coverage through the exchanges during October.

So we learned something from this release. But we didn't learn how many people had actually enrolled.