Obamacare

Obamacare's Enrollment Target Slips Away, and Other Takeaways From Today's Enrollment Report

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Whitehouse.gov

In September 2013, the month before Obamacare's health insurance exchanges launched, Health and Human Services Secretary Kathleen Sebelius was asked by NBC News what success would look like for Obamacare. "Success," she responded, "would look like at least 7 million people signing up for coverage by the end of March," the final month of open enrollment for the health law's first year.

But based on the administration's report this afternoon that just 4.2 million people had signed up for coverage by the end of February, that goal now looks all but impossible to reach.

With open enrollment ending in just a few weeks, there's not much time left to make up the gap. Indeed, even if there's a significant sign-up spike in the final month, the administration is still likely to significantly undershoot its target.

We'll find out soon enough. In the meantime, here are the key takeaways from today's enrollment report.

The administration is still well behind its initial enrollment target—which now seems out of reach. Even with relatively steady sign-ups in January, and a so-so total February, the pace hasn't picked up enough after the slow opening. The administration is counting on a spike in March to make up lost ground, but it's going to have to be really big to even come close. About 1.78 million people signed up for coverage in December, the month with the highest number of sign-ups so far. The administration needs a 63 percent increase from that month's turnout to get the 2.8 million sign-ups necessary to reach 7 million by the end of March. Even hitting the Congressional Budget Office's revised estimate of 6 million sign-ups by the end of March seems like something of a stretch at this point. 

The administration is still counting sign-ups, not completed enrollments—so the real number of paid enrollments is substantially lower. The monthly "enrollment" reports released by the administration don't actually count enrollments. Instead, they count people who have "picked a plan" within the exchange system. But multiple reports from insurers suggest that about 20 percent of people who sign up aren't paying their first month's premium, and thus aren't enrolled. Other reports suggest a further attrition through non-payment of around 2 to 5 percent in the second month. What this means is that whatever the final number of sign ups is, the true number of enrollments will be significantly smaller.

The percentage of young adults signing up isn't increasing. When it started to become likely that the administration wouldn't meet its enrollment goals for the year, the White House changed the definition of success, arguing instead that what was really important was getting a healthy demographic mix of enrollees, with around 39 percent of enrollments coming from young adults aged 18-34. In December, the administration, along with other supporters of the law, pointed hopefully toward the increasing number of young adults as a sign that the demographic mix might work out. But the percentage of young adults who've picked plans has barely budged since then. At the end of December, 24 percent of sign-ups were between 18 and 34; now, at the end of February, it's still holding at 25 percent.

California still leads the way. Of the 4.2 million people who've selected a coverage option, 868,936 are from sunny California. No other state even comes close; the next highest sign-up totals come from Florida (442,087), Texas (295,025) and New York (244,618).

There are large disparities between the states. In contrast to states like California, states with broken exchanges, like Hawaii and Massachusetts, still have tiny sign-up totals. Massachusetts has signed up just 5,943 people for coverage. Hawaii has signed up 10,968.

The vast majority of people signing up for coverage are eligible for subsidies. The administration reports that 83 percent of those who've picked plans qualify for the health law's tax credits to purchase insurance—a figure that has risen slightly over the last few months.

More women are signing up than men. Of the 4.2 million people who have picked plans so far, 55 percent are women and 45 percent are men. That makes sense since the law prohibits differential pricing based on gender. But it also suggests that the risk pools in the exchanges will be weighted toward people who are generally more expensive to insure. 

This doesn't tell us how many uninsured people have gained coverage under the law. Even if we knew how many of the sign ups were paid enrollments, that would not tell us how many previously uninsured people were gaining coverage thanks to the law. Survey data suggests that the number is much smaller than the overall sign-up totals, perhaps just a quarter of all people signing up for coverage. But the bottom line is that we just don't know, because the administration is not systematically tracking that data. 

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  1. More women are signing up than men. Of the 4.2 million people who have picked plans so far, 55 percent are women and 45 percent are men. That makes sense since the law prohibits differential pricing based on gender. But it also suggests that the risk pools in the exchanges will be weighted toward people who are generally more expensive to insure.

    When are they going to outlaw “differential pricing based upon gender” in the auto and life insurance markets?

  2. So this whole ACA thing isn’t going well?

  3. It now seems clear that there are going to be large numbers of voters from mostly Democratic states who will have not signed up for coverage, because they physically can’t.

    Hence a delay of the individual mandate seems all but inevitable.
    You can’t seriously propose penalizing people for not signing up for a plan if their state exchange doesn’t work. And this will hurt Democratic states the worst, since they are the ones with the non-functioning state exchanges.

    1. You can’t seriously propose penalizing people for not signing up for a plan if their state exchange doesn’t work.

      Sure you can. Fuck ’em for living in that state. It’s like withholding highway funds or education subsidies if the state doesn’t tow the lion.

      1. You can’t seriously propose penalizing people for not signing up for a plan if their state exchange doesn’t work.

        I propose following the law. If the law is that bad, change the law. By amendment passed through Congress and signed by the President.

    2. It doesn’t matter to the Dem voter. What are they going to do? Vote for the Republicans?

      1. Not voting at all is almost as good.

  4. But the bottom line is that we just don’t know, because the administration is not systematically tracking that data.

    Due to limited resources, they’re restricted to systematically tracking the Russian invasion of Ukraine.

    1. Lucky for Ukrainians, they have government guaranteed healthcare to fall back on in this crisis!

  5. We’ve analyzed the enrollment, secretary, and there is a danger. Should I have your ship standing by?

  6. But the bottom line is that we just don’t know, because the administration is not systematically tracking ignoring that data.

    Fixed.

  7. With open enrollment ending in just a few weeks, there’s not much time left to make up the distance.

    Well, like the specifics of the law itself, the enrollment target was just kind of a loose suggestion.

    1. We’ll find out what the enrollment target is when we reach it.

    2. Word.

      Just skim through that monstrosity if you haven’t yet had the pleasure.

  8. The administration reports that 83 percent of those who’ve picked plans qualify for the health law’s tax credits to purchase insurance

    Free market solushun, bitchez

    1. So, what’s the correct figure, then?

  9. There is a special US House election tonight in Florida. The district has voted 49% for Obama over the last two elections.

    Many of the Peanuts have been saying that DOOM IS COMING! for Democrats due to Obamacare foibles. Tonight’s election will give us a preview of the midterms.

    I predict the Peanuts are wrong (again).

    1. Yeah, just like the special election in the 12th district of PA predicted Democrat success in 2010

      /derp

    2. No, Florida’s special House election won’t predict November’s midterms

      There are about as many Democratic districts as Republican-held districts that look competitive at the moment, which means one party would really need to catch a wave to win them all and affect the current balance of power in the House. Moreover, those competitive races make up only a fraction (about 15 percent at the outside) of all the House seats, leaving neither side much room to maneuver. In other words, the staunch partisanship and safely-drawn districts help keep special elections like this one from predicting too much beyond their boundaries.

      Which means: The Buttwipe is making the same mistake that he ascribes to others. Typical of him, of course.

    3. Palin’s Buttplug|3.11.14 @ 4:24PM|#
      “There is a special US House election tonight in Florida…”

      Go fuck your daddy, shitpile.

    4. Well, Jolly just beat Sink, so Mr. Buttplug is wrong again.

    5. Looks like DOOM IS COMING! Can’t happen to a nicer bunch of folks. Enjoy the whole reaping what you’ve sown part of our agenda kiddies.

  10. Even if you don’t read the articles, you can tell how well the ACA is going from the fact that MSNBC and Slate and Salon have stopped writing about it. No news is not good news. If there was anything even slightly positive, we would have banner headlines from the left-wing sites.

    It seems word has gone out to move on from defending the legislation (Matt Yglesias’ “I’m going to go on record as predicting that implementation of Obamacare is going to be a huge political success” has to go on the list along with “The End of War”, published in 1913) to pretending that it doesn’t even exist. Even something as simple as publicizing success stores (and surely there are at least a dozen or two people who feel better off) seems to have been abandoned, as anything that reminds anyone that ACA exists, and was passed by Democrats, is not off-limits.

    1. There was this from a few weeks ago: How Silicon Valley Saved Obamacare, and Obama, and the Democratic Party. I consider it wildly optimistic.

    2. And I am still waiting for a follow-up on this: Accenture Faces Mid-March Healthcare.gov Deadline Or “Disaster”. I don’t think the back end of the website is done yet.

  11. “My goodness, Your Eminence, that is quite simply the most beautiful suit of clothes I have ever set my eye upon!”

    1. Paraphrasing shreek?

  12. Well Obo, your foreign policy is a steamy pile and your record on civil liberties is too, but at least you have your signature accomplishment, Obamacare.

  13. Sheesh, quit harassing the administration already, Suderman.

    1. Particularly when they’re doing such a good job of it with no assistance from anyone.

  14. Don’t mention Obamacare. I mentioned it once, but I think I got away with it all right.

  15. “Success,” she responded, “would look like at least 7 million people signing up for coverage by the end of March,”

    She’ll explain that’s end of March, 2015.
    If it weren’t for the wheels, that goal post would just fall over.

  16. There’s a healthcare.gov ad on the page as I’m reading this article.

  17. Note: It’s already pretty easy to get a waiver from the mandate.

    http://online.wsj.com/news/art…..25596.html

  18. How’s the ACA doing? So poorly that IT should sign up for health care. First “Patient Protection” was dropped from the (former) PPACA. And now Obama — he of the immensely busy laser-focused-every-waking-minute-on-the-economy schedule that mostly consists of a 10 AM start followed by meeting celebs and campaigning, is reduced to swapping humorless “jokes” on “Funny or Die”.

    Too bad that verdict doesn’t apply to Obamacare (the title that some consider a slur, even those OFA uses it in their emails.).

    1. edit: even THOUGH

  19. I’ll bet you anything that the government will end up giving the insurance companies a lot of taxpayer dollars (under the guise of defraying startup costs) to prevent them from raising premiums to cover the cost when the young, healthy people don’t buy in.

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