Obamacare

More Signs That Obamacare Exchange Enrollment Is Dropping

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Whitehouse.gov

There are now multiple indicators that Obamacare enrollment may be lower than reported by the administration—and dropping in the "off season" between sign-up periods. The latest comes from Florida, where June enrollment in private plans through the federally run insurance exchange in the state is about 760,000—or about 220,000-persons lower than the 980,000 total reported by the administration following the end of open enrollment, according to an official with the Florida Office of Insurance Regulation.

If that figure, reported last week by the South Florida Business Journal, is correct, it represents a 22 percent decline from the total reported by the administration's Department of Health and Human Services in April. A separate report today indicates that the decline is just 120,000, to about 866,000, but that refers to "individual plans under the Affordable Care Act," which may include Obamacare-compliant plans not purchased on the exchange.

Either way, it's a big—perhaps very big—drop from the administration's headline number. And it's not the only figure we've seen indicating that the actual numbers are quite a bit lower than the administration's official tallies.

Recall that the administration's enrollment numbers are based on people who signed-up for coverage, not steady, paying customers. Not all of them were going to convert. The question was how many would decline to pay at all, or drop out of coverage soon after making an initial premium payment.

For one of the nation's largest health insurers, the decline appears to have been pretty steep. Aetna's 720,000 sign-ups turned into just 600,000 paying customers by June, according to an August Investor's Business Daily report. The company expects paid enrollment to drop down to close to 500,000 later this year—a roughly 30 percent decline.

The same IBD report noted that the official enrollment tally in Washington state dropped from 164,062 in May to 156,155 in June.

What's the overall trend here? It's impossible to say. The administration, which released monthly reports on sign-ups throughout the health law's first open enrollment period, stopped releasing those reports, and now says it doesn't know if or when the reports will continue, or, if they do, what information they might include.

The best indication we've seen so far on overall activity on the exchanges following the end of open enrollment this year comes from Pro Publica, which in July reported unexpectedly high activity—including new sign-ups, dropped plans, and other changes to enrollment status—on the exchanges. No exact counts were provided, but less than half of the activity came from new enrollments, according to an industry source.

All of which suggests, but does not definitively confirm, that enrollment on the exchanges may not be holding up between sign-up periods. The administration has always made it hard to know exactly how many people were enrolled under the law, thanks to its imprecise sign-ups metric. But those reports at least provided a rough sense of what was happening within the exchanges. Now, without regular updates, we don't even have that. Administration officials should continue to provide monthly reports and state-by-state breakdowns, as well as the paid enrollment totals that have never been provided. Until it does, it's reasonable to assume that whatever is happening with enrollment, they don't want anyone to know. 

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  1. What’s the overall trend here? It’s impossible to say.

    Not really. Every single data point shows a double-digit drop.

    All of which suggests, but does not definitively confirm, that enrollment on the exchanges may not be holding up between sign-up periods.

    When every single data point supports a single conclusion, I’m pretty comfortable saying that conclusion is confirmed. What you need for “definitive” confirmation is up to you, of course.

    1. So, more than an 8% decline?

    2. yeah. “Can’t say for sure” implies some kind of contrary evidence. When all of the available evidence points one way, you likely can say “for sure” or at least with a pretty fair degree of certainty.

      But to be fair to Suderman, he does have to go home and explain his posts to his wife. And if there is one thing Mrs Suderman is down with, it is forever and always giving the benefit of the doubt to Obamacare.

      1. I think Suderman is wise to be painfully objective.

        We need to make our case to people who thought ObamaCare was a great idea–Suderman’s not just preaching to the choir, and that should be applauded.

        Why should Suderman slant to one side about what most people perceive as uncertainties when Suderman’s facts and analysis point in the right direction–even when he’s being painfully objective?

        1. I was not making fun of Suderman. I was making fun of McArdle. McArdle’s constant “now we don’t know for sure” spin on everything from Obamacare to NSA spying to the IRS scandal has long since become painful to watch. Sudderman is not and never has been that bad.

          That said, he is venturing into McArdle territory here. There is no rational reason to think the numbers are anything but awful.

        2. I think Suderman is wise to be painfully objective.

          What’s not painfully objective about saying that every source of data points to double-digit declines within a few months of open enrollment closing, and that there is no reason to believe that these data points are not indicative of the whole program?

          1. How ’bout because the people who provide this information either work for the Obama Administration directly or are regulated by the Obama Administration and are so afraid to tell the truth that we might get a bunch of bogus data coming out that uncertainties–that makes it look like Suderman didn’t know what he was talking about.

            Eventually the truth will come out, but in the meantime, why should Suderman give the wolves his bones to chew on?

            1. Sure, Ken. Throw that in.

              Every source of data, all of which comes from sources with incentives to, what’s the phrase, “hide the decline”, nonetheless points to double-digit, etc.

              It would be one thing if the data was coming from sources with incentives to make it look really bad. But its not. Your observation actually supports “confirmation” of the trend.

              1. I agree!

                What I’m talking about is Suderman allowing for whatever uncertainties–to readers and other journalists who aren’t libertarian, Republican, and and may be entirely hostile to libertarians and Republicans.

                In recent weeks, we’ve seen other journalists go after Reason staff (both current and people from the ’80s) entirely without cause–why give them a reason?

                All indications are that the data is and will be damaging to the Obama Administration.

                I agree.

                I thought we were talking about whether Suderman should needlessly stick his neck out–when he can stay painfully objective and, more or less, tell the same story anyway.

                If the implications are obvious to us, they might be obvious to less biased observers, too. And, yeah, I’m biased against Obama–for good reason. I don’t give him the benefit of the doubt on anything. If Obama told me it was raining outside, I’d pack sunscreen.

                1. Its the “more or less tell the same story” that I’m quibbling about. And I freely admit its a quibble, but for a publication that should be characterized by scathing skepticism of self-serving government activities, its kind of disappointing.

                  I think there’s a difference of tone and emphasis between “Eh, who can be sure” and “Every source of data, all of which comes from sources with incentives to, what’s the phrase, “hide the decline”, nonetheless points to double-digit, etc.

            2. What Megalo said.

              The fact that the information is coming from Obama is further proof it is horrible. If it were good, they would release it.

      2. Speaking of Klein, his buddy Sarah Kliff writes an article that drops a bombshell that will certainly be completely ignored:

        3) Half of all healthcare spending goes towards 5 percent of the population

        Americans are not equal health care spenders. There’s a handful of patients who use lots of medical services ? and tens of millions of people who barely go to the doctor at all.

        The National Institute for Health Care Management estimates that, in 2009, about half of health spending ($623 billion) went towards 5 percent of the population. On average, these are people who use $40,000 of health care annually.

        I have been yelling about this for years. Let me get this straight: we had to “overhaul” the healthcare system in this country to control costs even though the average cost for 95% of the public was what, $211? Fuck me, the media is so thoroughly dishonest I could kill someone.

        1. I don’t know why that people find that surprising or even disturbing. When the statistic says “5% of the population” it means “the sick”. Most people are not sick and don’t require much health care. Why would someone who is healthy consume any health care costs?

          That statistic is right up there with the “80% or whatever of a person’s life time health care expenses happen during the last six months of their life”. Well no shit. That is when they are six and need it most. We can’t do much about that, however, since we don’t know that it is their last six months until after the person dies. Sometimes they live.

          All any of these sorts of statistics do is make the point that health care costs would be a hell of a lot lower if we would just stop treating sick people. While true as far as it goes, I am not really sure it makes the point the people siting these statistics want them to make.

          1. All any of these sorts of statistics do is make the point that health care costs would be a hell of a lot lower if we would just stop treating sick people.

            Which is why in 5 years, when this screwy system becomes unsustainable, is exactly what will happen. The FedGov will call it “prioritizing”. It will in fact be rationing. Sarah Palin called them “death panels”. And she was right.

            1. She was dead on right. But hey, she is a stupid bimbo. What did she know.

            2. …”Sarah Palin called them “death panels”. And she was right.”

              The left will give them some name like ‘life choices’ and similar to commie-kids fake wind-energy data, they will then claim there are no ‘death panels’.

              1. kind of like “pro-choice” really means “kill babies”

        2. from the Article:

          There are more nuanced ways that our health-care prices are more expensive, too. Harvard University’s David Cutler points out that we have much higher administrative costs than most other countries ? and those costs get tacked onto the bill when we go to the doctor. The average American doctor spends All those extra billing specialists’ salaries have to get paid somehow ? and that gets worked into our prices.

          It’s like they see the same problems we do.

          1. To bad they don’t have any kind of ability to determine the source. Instead they think negotiating medicine prices with companies is the solution and more oversight. I don’t understand how someone who sees the exact problem I do can come to such a radical different solution.

            1. Their solution will be twofold; more regulations and oversight for the purpose of reducing administrative costs (I am not kidding) and rationing of care (see my post above). Expect to hear a lot of “we need to be more efficient” and variations of “we are spending all of this money on these few people, why not just cut them off”.

              1. +1 NHS

              2. The washington post had radio spot last week where the hook was “want a better, more efficient Gov.? Than the feds should add a million new Gov. jobs. The case for more bureaucracy in this Sunday’s outlook section” It’s like they don’t understand what words mean anymore.

                1. it really is beyond parody.

              3. I don’t think the solution they envision to the administrative cost is more regulation, I think that’s their pitch for why we need to eliminate all those inefficient middle-men and just have the hyper-efficient federal government run the whole show.

          2. Its almost as if having the government pay the medical bills of the old and the poor isn’t a good idea or something. Like maybe there are limitations to the things government can do. Who could have seen that coming?

    3. I think he could have clarified it by saying:

      “What’s the overall trend here? It is impossible to to say exactly.”

      Is it a double digit drop, a single digit drop, more? Etc. Everyone knew there would be a drop off from ‘shopping cart’ to becoming a regular paying customer. But, no one knew how much of a drop off there would be. And, we still don’t know. Because the Admin won’t let us know.

      What irritates me is if a public company gave out shoddy numbers like these trading would be halted and likely the CEO would step down and forensic accounting brought in.

      1. “What irritates me is if a public company gave out shoddy numbers like these trading would be halted and likely the CEO would step down and forensic accounting brought in.”

        And Obo’s lap-dog press would be all over it!

    4. I agree. The administration’s numbers were never accepted by anyone with a working brain. Even in April, extrapolation from the few data points indicated that the actual number of paying customers would only be in the neighborhood of 5.9 million. Now, with some time and experience, that early number may have been a good estimate. But no matter how one slices it, the real result confirms the failure of obamacare.

  2. Better to close your books and be thought a failure, than to open them and remove all doubt?

    1. And if the truth were anything but “so awful even Ezra Klein couldn’t spin this with a straight face”, don’t you think they would be releasing it?

      1. Maybe the enrollment numbers are actually through the roof, and they’re saving it for an October surprise!

        so awful even Ezra Klein couldn’t spin this with a straight face

        Is there any such level? That seems like one of those “can jesus microwave a burrito so hot even he can’t handle it” sort of things.

        1. No there is no such level. You really have to wonder how much contempt the people in the White House must hold people like Klein and Sad Beard. That much obsequiousness has to breed resentment among its objects.

    2. All-Seeing Monocle|9.2.14 @ 1:27PM|#
      “Better to close your books and be thought a failure, than to open them and remove all doubt?”

      And the lap-dog press isn’t gonna go searching for the data.

  3. it’s reasonable to assume that whatever is happening with enrollment, they don’t want anyone to know.

    “We treat the privacy of our Obamacare guests with the utmost seriousity.”

    1. “We can’t comment on a pending investigation. Oops, I mean, uh… HIPAA, or something.”

    1. Is he out of prison?

  4. “The administration, which released monthly reports on sign-ups throughout the health law’s first open enrollment period, stopped releasing those reports, and now says it doesn’t know if or when the reports will continue, or, if they do, what information they might include.”

    Well, once the headlines said the right things, the science was settled.

    What’s the point of giving people accurate information if that information can only be a disappointment? …what difference does it make?

    It’s really important to understand, the primary purpose of ObamaCare was always to manage the perceptions of voters at various points in the election cycle. Especially ahead of the midterms, why would the Obama Administration want voters to have accurate information right now?

    1. If the information was good.. As Monicle points out above, the information is so horrible as to be beyond spin and thus must go down the memory hole. Good thing we have a healthy skeptical media that is really holding them to account for this, right?

      And the point of Obamacare was always to pass something to save Obama’s sorry ass in 2012.

      1. “And the point of Obamacare was always to pass something to save Obama’s sorry ass in 2012.”

        That’s right!

        The point wasn’t to actually come up with effective public policy on healthcare–it was to manage voter perceptions ahead of elections.

        It was about Obama’s reelection in 2012 (which is why so much didn’t kick in until after he was reelected), and not releasing bad news now isn’t completely divorced from the midterms.

        Why the hell would a mendacious bunch like the Obama Administration release anything ahead of a midterm election?

        After the midterms, by the way, I still expect Obama to take the gloves off.

        1. IF the midterms are the disaster for the Dems that it looks like they might be, it won’t be Obama taking the gloves off, it will be the remaining Democrats in Congress and Obama will be the target.

          Obama won’t agree to even a modest fix of his “signature achievement” and Democrats in Congress will not tolerate continuing to get blamed for its failures. It is going to be ugly. And it couldn’t happen to a more deserving bunch.

          1. I think that recent blurb about the Obama Administration seeking a non-binding, no Senate approval needed, climate treaty was the kind of thing we can expect in the future.

            Didn’t it seem to be a vote of no confidence by the Obama Administration as to how they think the Democrats are going to do in the upcoming?

            These things take time, and if Obama wants to get something done before he leaves office, he needs to plan ahead. And when he plans ahead? He thinks whatever he does will need to somehow not require any approval by the Senate?

            LOL

            1. For sure Ken. And when he says fuck it and goes completely off the reservation, the Democrats in Congress and the country in general will turn on him.

              No one believes me, but I bet they impeach him. You watch. It won’t be the Republicans who impeach him, it will be the Democrats. Obama really does not give a fuck about anyone but Obama. He won’t care if his actions cause the ruin of the Democratic Party. I think a few of the smarter Dems are starting to figure this out and are getting very scared. They should be.

              1. If he tries to bypass Congress and the Senate because he didn’t like the election results they have to impeach. How could they not?

        2. After the midterms, by the way, I still expect Obama to take the gloves off.

          The *nitrile* gloves, I presume.

    1. Wow. Just…. wow.

      1. She looks like she’d settle for a job as a restaurant critic.

    2. “I’m a majorette in drama.”

  5. According to the Gallop, the fraction of population that is uninsured has gone down this year.

    See http://www.gallup.com/poll/168…..rops.aspx/

    However, according to hospital managers who I know, the number of uninsured people who think they have insurance has exploded.

    1. I have no doubt that your hospital managers are right. The irony of these people being bitten in the ass by their own low information voters is delicious. I guarantee you a large number of people out there to this day think that Obamacare meant they automatically got free insurance. Boy are they going to be pissed when they find out otherwise.

    2. Ding, ding, Cato.

      What we are seeing is people who either fucked up their enrollment, aren’t paying their premiums, or are just now coming to the realization that “deductible” means “You pay. Sucker.”

  6. The people who are really going to get burned are self-employed who are right at 400% of poverty line, work a bit of overtime, and lose the entire ACA tax credit. In my case, the marginal income tax rate at 400% of poverty line is 720,000%.

    In fact, this year the $1.00 I earned over the 400% of poverty line income cost me $7,200.00 in additional taxes.

    I knew about this in advance and earn significantly more 400% of poverty line. A lot of schmucks aren’t so fortunate.

    1. To the people who wrote this bill, keeping people above but not too far above the poverty line is a feature not a bug. If we let you grow your business, you might compete with someone who matters. And we can’t have that.

      1. The progressive true-believers and the Obamatons are indeed that bad.

        However, in my experience, most Democrats are unable even to grasp that it is possible to impose a 720,000% marginal income tax when I attempt to explain this little ACA gem. They can’t believe that something so ridiculous could possibly be true. I doubt that most would support if they could understand it. And certainly the vast majority of the Democrats in Congress had no clue about what was in the ACA.

        1. You are right about that. Most people lack the reasoning skills necessary to understand that. But they will after it happens to them. Like I said above, they are going to get bit in the ass by their own low information voters.

          1. Eh, most people don’t even understand how marginal income tax rates work, or how an effective rate is different, or really anything else about income taxes. They just hand their W-2s to a tax preparer or use turbo tax.

        2. They can’t believe that something so ridiculous could possibly be true. I doubt that most would support if they could understand it.

          You’ve told them, so they understand it.

          They just are in denial about it. They would rather hold onto their proggy/TEAM BLUE UBER ALLES worldview and narrative than face the facts.

  7. I am really wondering what will happen next year when the IRS starts asking whether everyone has insurance, and penalizes those who say “no.” Or has that part been delayed (again)? I can’t keep track.

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