Obamacare Sign-ups Pass 6 Million

Sebelius said last year that 7 million is what "success looks like."


Yesterday President Obama announced that over 6 million people have signed up for health coverage through the Obamacare exchanges ahead of the March 31 deadline. The news came shortly after it was reported that those who begin the enrollment sign-up process before the deadline but don't finish in time because of technical difficulties will be allowed to apply for an extension.

From CNN:

President Obama announced the milestone Thursday in a call with enrollment counselors and outreach volunteers, who are undertaking an intense marketing drive in the final days of open enrollment. There were more than 1.5 million visits to HealthCare.gov and more than 430,000 calls to the call centers on Wednesday.

Those who've started the application by next Monday but are unable to finish because of technical issues will receive more time to complete the process, officials have said.

Reaction, Analysis, and Commentary:

Politico notes that a year ago, Secretary of Health and Human Services Kathleen Sebelius said that having 7 million people enrolled through the exchanges is what "success looks like." The CBO made the 7 million prediction in May. In February Sebelius said, "I'm not sure where they even got their numbers," and Vice President Joe Biden said "we may not get to 7 million, but if we get to 5 or 6 million that's a hell of a start."

From Politico:

A year ago, Health and Human Services Secretary Kathleen Sebelius was calling 7 million enrollees what "success looks like." Thursday, administration officials went wild announcing they'd hit 6 million, with four days still to go before the deadline.

The argument seems to be: it wasn't a disaster. Enrollment didn't live down to Republicans' apocalyptic predictions. Bad as the website was, people wanted so much to sign up that they kept coming back until they had.

"Important to remember that back in October and November, everyone thought getting to 6 million was impossible," tweeted White House senior adviser Dan Pfeiffer, traveling with President Barack Obama in Rome. "Amazing comeback story."

What looks like a comeback to Pfeiffer comes across more like a convenient readjustment of expectations to opponents of the law.

Yesterday Vox Senior Editor Sarah Kliff tweeted the following chart, which shows the projected and the actual enrollment numbers by month:

Ricardo Alonso-Zaldivar of the AP notes that because each state has a different insurance market, it is the state enrollment numbers that really matter:

Although the national number is important, what really counts is state-by-state enrollment. That's because each state is a separate insurance market. To help keep premium increases in check, each state market must have a balance between young and old, healthy and sick.

"The national number only gets us so far," said Caroline Pearson, who is tracking the rollout for the market analysis firm Avalere Health. "The fair measure of success is whether you have set up a market that is sustainable into the future. So you can then go out and find the rest of the uninsured people, and bring them in over the next couple of years."

As of just a couple of few weeks ago, it seemed like it would take a miracle of sorts for the administration to hit the 6 million mark. Enrollment in February was lackluster. But this week especially has seen a resurgence of consumer interest with the enrollment deadline approaching. The administration said HealthCare.gov got 1.5 million visits on Wednesday.

Reason's Peter Suderman wrote yesterday about how the administration's sign-up totals don't provide the full picture when it comes to the actual number of people enrolled:

The problem, as always, is that the administration's sign-up totals don't give us a firm hold on how many people have actually enrolled, because many of the people who are counted as signing up have only selected a plan using the online system; not everyone who has selected a plan has gone on to pay the first month's premium. Nor do the administration's numbers give us any sense of how many people who end up paid and covered stay that way in subsequent months.

Right now, however, our understanding of how many people who have selected a plan and then completed the enrollment process is somewhat weak. Multiple reports from January and February suggest that about 20 percent of sign-ups never submit a payment and don't end up covered.

But that's a rough approximation based on early reporting from a handful of insurers. It's not systematic. We don't know if payment rates have increased or decreased over the last month, or if people who select a plan in the final surge are more or less likely to make a payment. We don't have hard data from every insurer or state. Mostly, what we've got are solid but scattered news reports relying largely on insurance industry insiders.

At Kaiser Health News Mary Agnes Carey outlined the significance of the 6 million figure:

The Congressional Budget Office originally estimated that 7 million people would sign up for the exchanges by the end of the enrollment period. After computer problems botched the Oct. 1 rollout, the CBO revised that estimate down to 6 million. Federal officials have said they do not yet know how many people who have enrolled have paid their first month's premium.Insurance industry officials have reported that about 70 to 80 percent of enrollees have paid.

Reaching 6 million has both practical and political significance. The more enrollees there are, the more likely the risk pool will be balanced between sick and healthy individuals. That calculus will be based on enrollments at the state and local levels where premiums are set, say experts. Republicans have expressed skepticism that the law would provide affordable coverage for millions of Americans and called for its repeal.

Read more from Reason on Obamacare here