The latest enrollment data from the Obama administration show that 3.3 million people have signed up for private health insurance through federal and state insurance exchanges created under the Affordable Care Act. This figure represents all enrollment from Oct. 1 through Feb. 1. It includes both people who have and have not paid their first month’s premium. Of those people, 1,146,100 selected their health insurance plans in January, meaning there was a 53 percent increase enrollment last month alone.
This makes January the first month that the Obama administration has beaten an enrollment target. Back in September, way before HealthCare.gov’s botched launch, the Centers for Medicare and Medicaid Services projected that 1,059,900 people would sign up for private health insurance in January.
That’s the good news for HHS. Despite anecdotal evidence from some of the state exchanges that enrollment had leveled off in January after the big December pre-deadline surge, federal sign-ups are still sufficiently robust to beat a monthly projection. Which is not to say they’re on target to hit their overall sign-up goal for the first year: They’re still more than a million enrollees shy of where they hoped to be right now thanks to the Healthcare.gov Chernobyl in October and November.
Now, big question. How many of those 3.3 million are paid up and how many are soon to be kicked off the rolls by their insurers because they never ponied up for their first month’s premium? HHS is … less interested in that number.
No data today either on how many people have *paid* their first month's premium, HHS says.
— Sarah Kliff (@sarahkliff) February 12, 2014
Five days ago, Bob Laszewski phoned around to insurers and was told that, on average, about 20 percent of new enrollees in each plan have yet to pay their premiums. Apply that to HHS’s figures and they’re overstating sign-ups by more than 600,000 people. Worse, Laszewski says that nonpayment rates tend to be higher for larger insurers than for smaller ones, presumably because the latter have less of a bureaucratic nightmare to sort through after the December enrollment rush and were able to reach out to deadbeats before the payment deadline. If that’s true, the number of soon-to-be canceled enrollments may be even higher. HHS wants you to take away from today’s topline enrollment figure that they made it three-quarters of the way to their target for January 31st despite the horrendous first two months, but depending upon how bad the nonpayment numbers are, they may be closer to one-half of the way there.
Two more footnotes that HHS doesn’t want you to notice. One: The number of young adults who signed up last month was slightly higher than in the months before, which is good news for ObamaCare’s risk pools. The more “young healthies” there are forking over premiums for coverage they don’t really need, the more revenue insurers have to subsidize the old and sick. Even though the percentage is up, though, it’s still not close to where it needs to be. Right now young people make up roughly 25 percent of risk pools; HHS’s target for that group in order to produce sustainable pools by the sign-up deadline on March 31 was 40 percent. They’ll need massive numbers of “young healthies” to bite the bullet over the next seven weeks to make that happen. The deadline next month will probably generate another last-minute enrollment spike, but it’ll have to be enormous to move the dial. See now why they’re doing Youth Enrollment Day? They’ve got an adverse selection problem and not much time to solve it.
Two: This seems like … a lot.
About four-fifths of those choosing health plans to date qualified for financial assistance to help pay their premiums, administration officials said.
Fully 80 percent of sign-ups so far are being subsidized. I say it “seems” like a lot because I looked around for an HHS baseline projection to compare it to and couldn’t find one. If it’s out there, please send it along and I’ll update. A Twitter buddy sent me this piece from November quoting a Kaiser Family Foundation specialist as predicting that only 60 percent or so of enrollees would qualify for financial assistance. Could be that Uncle Sam’s on the hook now for more sugar than he expected, although it stands to reason that people who need subsidies might sign up earlier than people who don’t. If that’s so, then that 80 percent figure will plummet over the next seven weeks as more middle class people finally get around to enrolling. If it isn’t, ObamaCare’s going to end up being even more expensive than we thought.
As for how many enrollees were previously uninsured and how many had coverage before their plans were canceled by ObamaCare, HHS is playing that one close to the vest too. Go figure that if you strip a few million people of insurance, a few million people might sign up for a new insurance product they’re legally required to buy anyway.
Update: Via John Merline and Morgen Richmond, here’s the answer to the subsidies question: CBO estimated that five of every six O-Care enrollees, or 83 percent, would qualify for some sort of subsidy. Today’s four-fifths numbers is right in line with that. See the table below, with markings from Morgen.
In other news, CBO projects that fully 83 percent of ObamaCare consumers will be getting taxpayer money. Sheesh. A good point from Morgen, though: “I’m a little surprised – and skeptical – about the reported numbers because I thought a pretty substantial number of the enrollees were those who had lost existing coverage…and likely to be at an income range where they would not be eligible for a subsidy.”