2. This 7 million is definitely not the same thing as the 7 million insured individuals the CBO had projected the exchanges would cover this year, though it’s a convenient coincidence. Whatever Secretary Sebelius’s exactly meant when she mentioned the same number as a metric for success last fall, the actual plan purchases the CBO was projecting seem likely to short of the 7 million number: If 85 percent of sign-ups pay their premiums, to take one estimate, that’s about 6 million people who actually get plans.
Moreover, the CBO’s 7 million projection was for covered individuals over the course of the year — since it’s a budgetary projection, this is an average over the course of the year, and not a specific number of individuals (e.g., it could be 7 million people covered for the whole year, or 6 million covered for the whole year plus 2 million for six months each, etc.). Surely as many people will drop off the exchanges as will join them because they lose a job or other insurance later this year, so we shouldn’t expect too many net new signups. Paid enrollment could even shrink noticeably.
But if HHS continues to count anyone who picks a plan on the exchange as an enrollment — and someone who’s gained insurance thanks to the ACA – we could be seeing a substantially larger enrollment number by the end of the year, a good bit over 7 million. Which will be a meaningless number, since the question should be how many people the program is covering, not how many have ever enrolled, but it’s possible they trot it out. (They’ve certainly been shameless about the Medicaid numbers.)