Obamacare

Obamacare Sees Last Minute Sign-Up Surge, But How Many Enrollees Were Previously Uninsured?

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Whitehouse.gov

It's the final day for Obamacare's official open enrollment period. (The special open enrollment period for folks who miss out the first time around starts tomorrow.) The day started with a website outage. Between 3 a.m. and 9 a.m. the federal health insurance exchange at the heart of the law was down, and unable to process new applications.

Obama administration officials say it was a software bug that popped up during scheduled maintenance. It probably didn't have anything to do with the crushing traffic load that was reported over the weekend. Via The Wall Street Journal, enrollment points online and off were slammed over the last few days:

Federal officials said HealthCare.gov had two million visitors over the weekend. On Friday, the site had blocked people trying to log in for about two hours starting at 4 p.m. Eastern, and they were told to wait until the site had fewer users, said a person familiar with the site's operations. On Sunday, the site was holding up well, the person said, handling some 50,000 simultaneous users, up from a previous peak of 40,000.

Long waits to reach a federal call center for help also frustrated some applicants. Federal officials said the center received about 270,000 calls Saturday from people trying to apply by phone or resolve problems with their online application. 

The Journal, along with other news outlets, reports that enrollment centers faced long lines over the weekend. Combined with last week's announcement of 6 million sign-ups, it looks like this year's open enrollment period will finish with a last minute surge. At this point, I expect we'll see at least 6.5 million sign-ups by the end of today. It could easily be 6.7 million.

But as insurance industry consultant Bob Laszewski argues, this isn't the number we really want to know.

Of course, the more than 6 million enrollment the administration recently announced overstates Obamacare's success because this includes enrollments that were never completed since the person never paid the premium. There are lots of reasons why a consumer might not complete the enrollment. The person may have hit the enroll button a number of times and ended up paying only once. It may have been one of the infamous "834" transactions that never made sense and the consumer ended up having to enroll again later. Or, the person might have had second thoughts about the cost/benefit of Obamacare and decided not to move forward.

Then there were a measurable number of people who paid their first month's premium but never paid the second month's premium. I am told that 2% to 5% of January's enrollments never paid in February, for example.

Whatever the reason, the real enrollment number will likely be about 20% lower than what the administration finally reports. 

It's not just that the sign-ups figure provided by the administration don't reflect real enrollments. It's that they don't tell us about the net gain in the number of uninsured.

There are two important pieces of information we need to have before the country can really answer this fundamental question about the way Obamacare accomplished health insurance reform:

  1. How many people have actually paid and completed their enrollment?
  2. To what extent have we reduced the ranks of the uninsured—how many of these people who enrolled were previously insured and how many of them were previously uninsured?

Reporters often ask these questions and the Obama administration says they don't know. And, that's the end of it.

But these questions are easily answered.

Every insurance company knows exactly how many people it has enrolled and who paid their premium at the end of every billing period. How else would they be able to process the claims for these people?

We'll probably get this information eventually. And we'll certainly get surveys and other attempts to quantify the changes in the meantime. But I think it's going to be a while before we have a reliable count of how many have enrolled, and how many are newly insured. 

NEXT: A Pre-Marked Voter Registration Card? It's All in the Overrated Tradition of Democracy.

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  1. Also, it’s worth noting that anyone who signed up at the last minute is probably someone who didn’t really want insurance and/or doesn’t think the rates are affordable.

    It would be interesting to see what the breakdown of non-payment rates are for those who signed up in december vs. march. There may be a bunch of people who think they can avoid the penalty by signing up for one month of coverage and then dropping it.

  2. It’s bad enough for all the people who were kicked off their old plans and forced to sign up for this fupos. But then for the administration to take credit for them signing up is complete bs.

  3. Won’t somebody kill this nightmare?

  4. At this point, I expect we’ll see at least 6.5 million sign-ups by the end of today. It could easily be 6.7 million.

    DOOM!

    1. Obamacare got that Democrat elected to the House if Florida didn’t it? I mean every Democrat in America is running commercials saying how proud they are to have voted for it, right?

    2. Still short of the 7mm initially flagged as “success”. And that’s with 90 days of additional time.

      Let’s see

      (1) How many of these signups pay their premiums.

      (2) How many of these signups were previously uninsured (as in, not insured during 2013, not kicked off on 12/31)

      (3) How many of the reinsured are paying more and/or have a better plan in terms of network, deductible and copay.

      1. My prediction for all 3 answers is 8%.

      2. Hey, and 12/31 isn’t a hard date. I’m being kicked off my policy today! 3/31.

  5. Bloomberg was pumping that seven million served number like ESPN showing a replay of a game-winning Hail Mary catch.

    “Of COURSE it’s a success!”

  6. The answer: There will have been 6.5 million to 6.7 million signups, after the DHS enacts a new rule requiring insurance companies to keep people insured even if they haven’t made any of the first three months’ payments.

    Just wait.

  7. But as insurance industry consultant Bob Laszewski argues, this isn’t the number we really want to know.

    John (Red Tony) knows all these numbers.

    1. One of the benefits of not being retarded is understanding how to interpret numbers and know which ones are meaningful and which ones are not. Since you are retarded and functionally illiterate, you are unable to understand what those who are not retarded are saying to you.

    2. Hey Putins Buttplug…..you made the big time…Valarie Jarrett retweeted one of your offerings!

      The White House ?@WhiteHouse Mar 28

      “I am a staunch Republican, a self-proclaimed Fox News addict?and I’m here to tell you that Obamacare works.” http://go.wh.gov/enaTb7

      1. Funny how there seems to be an endless supply of “life time Republicans who just can’t vote for the party anymore” just like there is an endless supply of “long time gun owners who support the Brady Campaign”.

        Concern trolls will always be concerned.

        1. I was just being mean John….we all know that Putins Buttplug isn’t a republican but a true laissez faire liberal in the classic sense….his mom had him tested!

          1. I am well aware that the ACA is not laissez faire.

            But it is market-based.

            And it is far better than Medicare – which the GOP supports and adds new programs to.

            ACA GOP preference.

            1. You really, really like to ignore the part where the ACA forces some people into Medicaid, don’t you?

            2. I am well aware that the ACA is not laissez faire.

              But it is market-based.

              Word to yo mother.

            3. market-based

              This can mean anything as long as there is buying and selling. I want actual markets not “marked-based.”

  8. Even if you had the number, it would only be meaningful if you knew how many of those people wanted insurance before but couldn’t get it. One of them many false assumptions of this monstrosity is that everyone who doesn’t have insurance wants it and isn’t making the rational calculation to forgo insurance.

    Further, even if you didn’t have insurance before and wanted it and haven’t it now through Obamacare, that doesn’t mean you are going to be happy with the insurance or that you are better off. The existence of the penaltax means people will sign up for insurance that all things being equal they don’t view as a good deal. Coercing people into buying insurance with the threat of a fine is not going to make this thing successful or popular.

    1. And as I noted above, if you are waiting until the last weekend to sign up, you probably didn’t want or need it.

      This last bit is all about the milch cows who will be subsidizing the people that signed up in october.

      1. The entire act depends on the young, healthy middle class being willing to be ripped off to support increased care for the poor and coverage for various sacred cows like birth control. It is a microcosm of why socialism always fails; the productive are never happy or willing to get screwed to help the unproductive.

        1. From an economic perspective, the big underlying problem is that when your premiums are not connected to how much money you are spending, your incentive is to spend more money.

          Community rating has the same effect as socialism, in that it destroys the informational feedback from price signals that is necessary to regulate market prices.

          The result is going to be skyrocketing premiums either way. Even if you can force all the healthy young people to sign up, you can’t get rid of the incentive to overuse the system that comes from everyone trying to get the most for their money.

          1. You can’t sell insurance if you are not allowed to price it based on risk. There is some pooling that is necessary in health insurance. The problem with pricing health insurance totally based on individual risk is that it makes insurance cheap right up until you need it. When you price something like car insurance individually, it works because you have control over your risk by being a good driver. But you have no control over your health insurance risk. Worse still, unless you die young, you will inevitably be a bad risk someday as you get older.

            A true system that charged by individualized risk for health insurance would end up looking like the life insurance market where anyone who is young and healthy can buy life insurance cheap but they slowly lose that ability as they age. That works fine for life insurance since people need it when they are young and not so much when they are old. It would be a disaster that would give us single payer in health insurance since people need health insurance more when they are old.

            They system of employer supplied health insurance worked better than people think by providing small pools that enabled older people to get health insurance without the full on damage of community rating.

            1. I suspect the market could come up with an appropriate pricing scheme for health insurance based on individual risk. Term health insurance is a possibility. You contract for 5 years with maybe a clause to renew for a year at the end of the term at the same price if you happen to get cancer 2 months before it expires.

              It’s worth remembering that the market is infinitely inventive.

              1. They would sell term health insurance just like they sell term life insurance. But the term runs out before you get old.

                And yes, the market is inventive. But it isn’t so inventive that it changes math. The fact is that someone who is 70 years old is a much worse health insurance risk than someone who is 30, all things being equal. The market is always going to account for that unless you want to intervene and distort it.

                That is the fundemental problem of health insurance policy; how do you price insurance based on individual risk but also make it such that health insurance isn’t like auto or life insurance in that it is only affordable for people who are unlikely to need it. Again, you can say “well old people just can’t buy life insurance” but you can’t really say “well old people or sick people will just lose their insurance as their risk grows too great for them to afford it.” That might be a rational answer. But it is not an answer society will accept. People will just demand single payer if that is the choice given to them.

                1. I think you lack imagination.
                  You could have a contract where you buy in while you are young and as long as you keep paying your premiums you are guarenteed a reduced rate (adjusted for inflation) when you get old.

                  You could require people to sign up before they hit 30.

                  Anything that government can do, the private sector can also do. Except use force. The only reason why “single-payer” needs to be government run is to force a bunch of other people to pay taxes to support you.
                  Otherwise, you could just form a health-coop and call it single payer.

                  “Government-run” is just a means to force people outside your co-op to pay into it.

  9. I still think Medicaid coverage does not equal access to care.

    1. It doesn’t mean “increased access to care”. All it means is doctors and hospitals can get some of their costs of treating the poor covered by the feds. From the poor person’s perspective, it really doesn’t mean much of anything. If it did, it wouldn’t be so hard to get people to sign up for it.

    2. I agree with that. Medicaid is more like a slow-walk ER visit. The problem is that we are going to pay either way and the ACA is cheaper in the end.

      The status quo has been maintained.

      1- private insurance
      2- Medicare
      3- Medicaid/ER

      And the ACA busts the cartel.

      1. The problem is that we are going to pay either way and the ACA is cheaper in the end.

        Because the government paying for something always makes it “cheaper”. And covering more of someone’s cost for something is not going to make them demand more of it.

        The ACA is going to send costs through the roof. By making people who previously didn’t have or want health insurance by health insurance, you are going to increase the demand for health care as those people rational put the health insurance they are paying for to use and go to the doctor more than they otherwise would have.

        Another of the great lies this bill was based on is the idea that getting people to go to t he doctor will magically lower overall costs through the wonders of “preventative care”. That of course is a fantasy sold to retarded people. You of course, being the target audience, believe it.

      2. I don’t think the ACA will be cheaper in the the end. not when you are paying to insure a population that may/may not even use the care. there are a lot of capitated models.

      3. The status quo has been maintained.

        Aside from the 1,000+ pages of regulations, dozen new taxes, and the individual mandate.

      4. And the ACA busts the cartel.

        Complete horseshit.

        1. Insurers operate an NGO that stores all medical procedures done on everyone for the purpose denying coverage to anyone with a preexisting condition.

          It is a pure cartel. They even collude on pricing.

          1. Now they don’t have to collude, since the Feds set their products and pricing and cover their losses. Just the kind of solution I’d expect from the Number One Capitalist.

            1. Not true.

              Insurers set all prices on the exchange. Don’t try to lie to me.

              And just like a state insurance commissioner sets coverage standards the ACA does as well.

              1. Insurers set all prices on the exchange. Don’t try to lie to me.

                They don’t have anything close to free reign in setting prices.

                And just like a state insurance commissioner sets coverage standards the ACA does as well.

                In other words, you concede.

              2. God you’re a gullible hack!

                C’mon boy tell us more!

                1. Sorry Jordan that was meant for Putins Buttplug.

      5. And the ACA busts the cartel competition.

        FTFY.

      6. the ACA is cheaper in the end

        How? It’s forced payments to for-profit corporations. It’s actually worse than universal single payer. That’s why single payer looks so good to so many people right now. “Hey, at least it’s not this pile of shit called the ACA/Obamacare.”

    3. I still think Medicaid coverage does not equal access to care.

      It certainly isn’t insurance, and the more people on Medicaid, the worse the global health care financing picture is, because those people don’t contribute. It just increases the distortions and cost-shifting, which OCare was supposed to alleviate.

      1. I am not sure it increases the cost shifting. Without medicare, the hospitals eat the cost of treating the poor and pass it on to paying customers. With it, they share some of that cost with the feds and pass the rest onto paying customers. The result is the same either way really.

        The root of the problem is the 1986 Act that prevented hospitals from refusing care. It made very hospital in America a charity hospital. Only people as stupid as our political class could be surprised that doing that sent medical costs for paying customers through the roof.

  10. I am told that 2% to 5% of January’s enrollments never paid in February, for example.

    “Wait- I have to pay that much every month? And I still have to buy my own bandaids? Fuck that.”

    1. Obama told me I was going to get free health insurance. What is this shit?

      It is really going to be funny in the coming months to watch nitwit Beltway Journalists try and come to terms with just how entitled many poor people actually feel.

      Expect to hear a lot of “those ungrateful bastards” gnashing of teeth.

  11. I still think Medicaid coverage does not equal access to care.

    Every time I hear somebody using health “insurance” and health “care” interchangeably, I get a powerful urge to do some eye-stabbing with my trusty old mechanical pencil.

  12. And the ACA busts the cartel.

    HAHAHAHAHAHAHAHAHAHA

    Wheeeeee!

    1. if by “bust” you mean “strengthen and fortify”

    2. Yeah, nothing busts a cartel like having the feds say you have to do business with the cartel, or else.

      1. Or having the Feds further restrict what products and pricing you can offer.

      2. Or forcing the cartel to include services the customer won’t use, and increase the price to offset it.

        1. “Jordan” is losing this argument for you upthread.

          1. You already conceded:

            And just like a state insurance commissioner sets coverage standards the ACA does as well.

  13. It’s the final day for Obamacare’s official open enrollment period. (The special open enrollment period for folks who miss out the first time around starts tomorrow.)

    And the *super* special open enrollment period for folks who miss out on the special open enrollment period for folks who miss out the first time around starts closer to the midterms.

    1. Next up:

      Retroactive insurance. Put a plan in your shopping cart before the end of the year, and you will be deemed insured for the entire year.

  14. (3) How many of the reinsured are paying more and/or have a better plan in terms of network, deductible and copay.

    “It’s an EXCELLENT plan. Gotta go. Wapner’s on in ten minutes.”

  15. We’ll probably get this information eventually.

    I’m guessing mid-November.

  16. Time to start working on your spin for this one, Putin’s SexToy:

    Avik Roy of Forbes said on NBC’s Meet The Press (3/30, Todd), “You have to hold the authors of the bill responsible for how it drives up the cost of health care,” and “a lot of people are seeing increased premiums. Next year it’s going to be interesting.” Roy added, “What we’re hearing from insurers thus far, they’re expecting double-digit increases for the cost of health plans on the exchange in 2015.”

    Sorry, from an industry email, no linkee.

    1. But RC, we had to pass it. We had to bend the cost curve. Think how expensive things would be if we had done nothing?

      One of the most infuriating things about this is how even some of the bill’s critics claim it is a middle class entitlement like Social Security or Medicare. It is nothing of the sort. This bill completely fucks the middle class. It is nothing like those two programs.

      1. as much as I think single payer would be a disaster, it would have at least made sense.

        1. Single payer is a horrible program based on a rational but totally unrealistic set of assumptions. This thing is based on assumptions that are not unrealistic, but are irrational and contradictory.

        2. Single payer requires strict wage and price controls.

          1. And the factor-of-four premium rule is what, exactly?

  17. Speaking of the noblest among us, selflessly providing health care services out of the goodness of their hearts…

    I broke down and made an appointment with an eye doctor (more than a routine prescription, unfortunately). When I asked the secretary to give me some sort of a ballpark estimate of what it was going to cost, she acted as if I had just taken a big shit on her counter. I’m supposed to just pay whatever number she pulls out of her ass, after the fact, and be grateful. She, on the other hand, has texted and called several times to “confirm” that I will show up, because her boss is much too important to be kept in the dark about whwether or not I’ll show. HIS time is valuable.

    I despise doctors.

    1. When we have single payer and he is your government assigned doctor and you are unable to go to anyone else no matter how badly he screws up or treats you, I am sure things will really improve.

      1. And the receptionists will be much more attentive to your questions and scheduling needs.

        –take a number – take a number – take a number – FORTY FIVE! …. FORTY FIVE! WHO’S FORTY FIVE?

  18. as much as I think single payer would be a disaster, it would have at least made sense.

    If the federal government wanted to block-grant funds to the states for “free” clinics for the poor (or anybody who had enough free time to wait for his number to be called), I’d say, go for it.

    Provided that meant leaving a private health care system in place, with major marketplace revisions on the supply both of doctors and insurance policies.

    1. Get rid of the “every hospital must treat regardless of ability to pay” law and then set up and fund charity hospitals in every city and town that treat anyone and then bills based on how much or how little money they have. It would clean out the ERs overnight. It would allow hospitals to charge their patients for the actual cost of treating them rather than the cost of treating them and also their pro rated share of the various poor people who walked through the door that month.

    2. that makes much more sense than buying “insurance” for the poor.

      1. Actually if we JUST bought insurance for the poor that would be an infinite improvement over the ACA.

        The ACA has the gall to not ONLY subsidize insurance for the poor, it had to rewrite the rules of insurance for everyone else too.

        You don’t need community rating in order to buy insurance for the poor.
        You don’t need to force all men to pay more to subsidize premiums for women.
        You don’t need to force post-menopausal women to purchase maternity coverage.
        You don’t need to mandate that healthy young people purchase a product that is three times the rational market price for their age group.

        The ACA isn’t just a program to help poor people get healthcare, it is social engineering on a grand scale, it is an attempt to redistribute access to healthcare for EVERYONE in society.

        1. It is massive social engineering. And like most social engineering it is insane and self contradictory. All of those coverage mandates would have made sense if they had just picked one or maybe two things to mandate.

          The idea behind mandating coverage is to force bunch of people who will never utilize the coverage to pay for it just the same. Providing birth control insurance is cheaper if your risk pool includes middle aged single men and 70 year old widows. So if they had just managed birth control or maybe maternity coverage or something else, they would have at least benefited someone. But instead, they mandated everything and inadvertently screwed everyone since no one benefits from every mandate but everyone pays for each mandate.

    3. And don’t forget Brooks, one of the provisions of the ACA is to discourage the creation of charity hospitals. I am not kidding. The concern is that if too many people set up charity hospitals, the poor and the middle class will be less likely to buy health insurance. So to prevent that, every hospital must do a “community needs survey” justifying why their services are needed in the community around them and present it to HHS before they offer any free services to the poor.

      If we had anything but a brain dead court media, that provision would be a national scandal. This fucking assholes are specifically trying to stop people from helping the poor because doing so might fuck up their Rube Goldberg scheme. That is a good part of the reason why they are going after the Catholic Church so hard. The Catholic Church runs a good number of charity hospitals. Force the church to shut those hospitals down and you get more poor people going on the government dole.

  19. Insurers operate an NGO that stores all medical procedures done on everyone for the purpose denying coverage to anyone with a preexisting condition

    That is unfortunate for people with pre-existing conditions, but that is morally and economically superior to forcing all market participants to pay for community-rated insurance in order to cover those people.

    1. They keep a record of the all of the car accidents I have been in as well. I really can’t see how my auto insurance company is immoral for looking to see what is in those records.

      Pre-existing conditions are a problem that requires some kind of work around. But they don’t require totally fucking everyone such that we all get treated as the same bad risk.

    2. It would have been much cheaper and caused much less damage to say, if you are denied coverage due to a pre-existing condition (and you can’t pay for things out of pocket, ie you’re not totally rich) then you are eligible for medicaid. Was that so hard?

  20. That is unfortunate for people with pre-existing conditions, but that is morally and economically superior to forcing all market participants to pay for community-rated insurance in order to cover those people.

  21. fucking tags.

    The whole object of the Obamacare is to destroy the concept of “insurance” in any meaningful sense of the word.

    1. When you understand that it was written by people who think that the govenrment has the power to magically will away difficult choices, you can see why it is out to destroy the concept of insurance. Insurance is based on risk and actuarial tables and other racist, middle class logic that white people have used to keep the poor and oppressed staying that way for centuries.

      1. Insurance is based on risk and actuarial tables and other racist, middle class logic that white people have used to keep the poor and oppressed staying that way for centuries.

        You and your boergeois mathematics.

  22. Are we really being told that there isn’t a deck page at Blue Cross with a fancy bar chart and a headline that says “Number of Insured has Increased/Decreased by X% year over year” done at the end of January? Because if it’s my company, that’s one of the three or four pieces of data I want. If Blue Cross management isn’t getting that chart, they should give me a call.

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