More Signs That Obamacare Exchange Enrollment Is Dropping



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.