Low Obamacare Enrollment More Proof of a ‘Disaster’
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The Fiscal Times
November 12, 2013

Before Healthcare.gov’s troubled launch on Oct. 1, the White House estimated nearly 500,000 people would enroll in the Obamacare health exchanges within the first month and an estimated 7 million were expected to gain private coverage by the end of March, when the open-enrollment period is scheduled to end.

Now – even before the administration can deliver on its promise to release an official head count of how many people have enrolled for insurance coverage in the first full month of operations – insurance industry analysts on Monday released figures showing the government has signed up a mere fraction of Americans it had hoped to recruit in October.

Robert Laszewski, a consultant to many major insurance companies, said in an interview that about 50,000 people have signed up for coverage in the 36 states that have federally designed insurance markets – or about 10 percent of the overall goal for the first month. That figure closely matches the 40,000 to 50,000 enrollments reported by The Wall Street Journal on Monday afternoon. Laszewski based his estimate on the number of completed transactions between individuals and their families and insurance companies.

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At the same time, Avalere Health, a health care consulting firm in Washington D.C., reported that 14 state exchanges have met just 3 percent of their enrollment goals for 2014. That means that 49,100 people have enrolled out of a targeted 1.4 million. This figure does not include data from California, Massachusetts and Oregon, which has not yet been released.

Until now, most of the state-run insurance exchanges have been touted as being bright lights in an otherwise dismal rollout. Avalere expects enrollments to begin to pick up on the state insurance exchanges late this year.

“People are slow to purchase coverage when new programs begin, and if past programs are any guide, we expect most exchange participants will wait until after January 2014 to enroll,” said Caroline Pearson, vice president at Avalere Health.

Even so, Laszewski, president of the Virginia-based Health Policy and Strategy Associates, described the overall situation as a “disaster.”

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“It’s a disaster in the states and it’s a disaster at HealthCare.gov,” he said. “There’s no way we can sugarcoat it anymore, and I don’t say that as a political shot at anyone.”

The federal online system is being overhauled, with Obama and other officials vowing to have the system fixed by end of November.

Jeffrey Zients, the management expert put in charge of retooling the website, told reporters Friday that while his team of government and private technical experts is making progress, an increase in user volume is exposing new and preexisting problems. That, according to Laszewski, was a tacit acknowledgment the administration had “already missed its Nov. 30 deadline.”

From the day he signed it into law, President Obama has repeatedly promised that his signature legislation would extend health insurance coverage to millions of uninsured Americans. So far, however, more people are losing their current health insurance policies than are signing up for new policies under Obamacare.

Here’s what stands out:

* The deluge of policy cancellations. About 4.2 million people have been dropped from their individual insurance policies so far, according to data compiled by the National Review Online. That’s likely to grow – data hasn’t been made available for every state. By year’s end, analysts expect some 7 to 12 million people to lose or be dropped from their current policies.

The plans being cancelled were purchased on the individual exchange and do not meet the standards of the new law. That means they don’t include coverage for maternity care, prescription drugs or any of the eight other essential benefits required under the ACA. Officials estimate that about 80 percent of plans purchased on the individual market will not be renewed.

* Appallingly low enrollment figures. Signups on the federal website have been so minuscule that the administration has kept the actual number of enrollments top secret. .

Some of the 14 states that operate their own exchanges have already released enrollment numbers for the first month – and the results appear to be mixed. For example, Washington State has the highest enrollment numbers, with about 49,000 individuals enrolled in both private health plans and Medicaid in the first month. New York enrolled more than 37,000 individuals; Kentucky signed up about 31,500.

The District of Columbia, on the other hand, enrolled just 300 people in its exchange ---or 1 percent. Only five people had completed the full enrollment process and paid the premium, according to data released by Sens. Chuck Grassley (R-IA) and Orrin Hatch (R-UT).

* The one shining success: Medicaid signups. While many states with GOP governors or legislatures opted not to accept expanded Medicaid coverage, the 25 states taking part have reported robust signup figures.

A recent Pew Charitable Trust Stateline survey of the 25 Medicaid expansion states and the District of Columbia indicated that at least 1.5 million people have already signed up for the joint federal-state health insurance program for low income Americans in 19 states that provided counts. Avalere Health put out a significantly lower estimate of 444,000, though it only included data from 10 states. 

Stateline found that the primary reason for the signup surge is that hundreds of thousands of people prequalified for Medicaid coverage because they already are enrolled in other state health care programs for the poor.

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This article was updated on Wednesday at 10:21 a.m. 

Washington Editor and D.C. Bureau Chief Eric Pianin is a veteran journalist who has covered the federal government, congressional budget and tax issues, and national politics. He spent over 25 years at The Washington Post.