Obama Administration Says 7.3 Million Paid Enrollments in Obamacare Exchanges as of August



The Obama administration said this morning that about 7.3 million people were paid and enrolled in insurance through Obamacare's exchanges as of August 15.

The figure represents a decline of about 700,000 from the 8 million the administration said were signed up for coverage at the end of April. The decline stems from people signing up but not paying, or from choosing drop coverage.

This is the first time the administration has provided a paid enrollment figure. Previous estimates for Obamacare coverage have relied on the number of people signed up, not the number of people who finalized their enrollment by paying.  

The 7.3 million figure is not quite current; instead, it represents a "snapshot" taken on a single day in August, Marilyn Tavenner, the head of the Centers for Medicare and Medicaid Services, told members of Congress this morning. 

Even still, that figure is likely to decline at least somewhat going forward. For one thing, it doesn't account for the 115,000 people who could lose their coverage at the end of September as a result of failing to verify their citizenship. Nor does it account for people who may choose to drop coverage after losing a subsidy because they failed to verify their income.

The figure is also potentially complicated by the 90-day grace period for premium payment the law requires insurers to abide by.

Tavenner's statement this morning said that, on August 15, "we have 7.3 million Americans enrolled in Health Insurance Marketplace coverage and these are individuals who paid their premiums."

Presumably, then, these are all people who have made at least one initial premium payment. But we don't know for sure if they kept paying; it's possible that some of them paid once and then failed to pay. Insurance industry consultant Bob Laszewski has said that insurers expect a monthly attrition rate of 2-5 percent even after initial premiums are paid. 

That would mean that most people who signed up in the final enrollment surge at the end of March and had coverage begin in May would be in the window, as would the 910,000 people who signed up in the special enrollment period in April, many of whom didn't have coverage go into effect until the beginning of June

An August 15 snapshot could be capturing people who paid the first premium for May or June, and then missed later payments. Without recurring report on sign-up and payment trends, however, it's somewhat difficult to tell. 

As Reason's J.D. Tuccille noted earlier this week, the grace period built into the law makes it possible for someone to sign up for coverage, not pay premiums, and use the coverage at a doctor's office—eventually leaving the doctor on the hook for the bill.

Still, the new figure suggests that the large declines in enrollment reported by Aetna, a health insurer which indicated that it could see as much as a 30 percent drop in its Obamacare plans by the end of the year, are probably not representative of any larger trend. And they suggest that overall paid premiums are at least somewhere in the range of the 7 million (perhaps a little lower or a little higher) initially projected by the Congressional Budget Office.