March 13, 2014

Administration Fails to Hit Obamacare Enrollment Targets, Other Metrics

This week, HHS issued its monthly report updating cumulative enrollment figures to include February data. The Administration claims more than 4.2 million people have signed up in the exchanges so far; 942,800 million of them in February. Unfortunately the report still doesn’t provide quantifiable metrics or answer key questions. Why won’t the Administration disclose objective data so that independent analysts can determine how much the law is helping or hurting the American people? Apparently this White House doesn’t want to face tough questions about its enrollment figures – especially when the data prove Obamacare isn’t working the way Democrats promised.

The report’s new enrollment figures should be read skeptically:

Monthly Enrollment Rate Falling. HHS hopes enrollment rates will spike as the March 31 deadline approaches, but this year’s sign-up rates continue to lag behind 2013 levels. Obamacare enrollment fell for the second straight month – 942,800 people selected plans in February, a drop from 1.15 million in January and 1.79 million in December.

Most People Eligible to Buy a Plan Didn’t Select One. HHS estimates 8.75 million people have completed the enrollment process and can pick an Obamacare exchange plan. Of those, only 4.2 million have actually selected a plan – a 48 percent take-up rate. This means that most eligible people who finished the Obamacare enrollment process decided not to buy a plan.

Taxpayer Subsidy Take-Up Rate. HHS reports that 83 percent of the 4.2 million people who selected an exchange plan will be getting taxpayer-subsidized coverage. However, while 5.25 million people completed the Obamacare application process and were deemed eligible to receive taxpayer subsidies to help offset the cost, only 3.47 million of them actually selected a health insurance plan – a 66 percent take-up rate.

Are People Buying in the Exchange Without a Subsidy? The HHS data indicate that people who do not qualify for taxpayer subsidies are not racing to purchase Obamacare exchange plans. Of the 3.5 million people eligible to enroll, but who did not qualify for a subsidy, just 689,973 selected a plan – a take up rate of less than 20 percent.

Exchange Sign-Ups Continue Trending Older and Sicker. HHS Secretary Kathleen Sebelius said that seven million sign-ups by the end of March – including 2.7 million young, healthy adults – is what “success looks like.” So far, only approximately 1,075,990 – 25 percent – of Obamacare exchange sign-ups are between the ages of 18 and 34. The Administration estimated it needs young adults to comprise at least 39 percent of the Obamacare risk pool. According to the HHS analysis, adults 35 and older currently account for 69 percent of total sign-ups. If this demographic composition holds through the end of the March 31 open enrollment period, premiums could skyrocket.

How Many People Paid Their First Month’s Premium? The Obama Administration’s report still doesn’t provide transparent enrollment data. It continues to count people as “enrolled” in Obamacare if they successfully selected a health insurance plan, but until people pay the first month’s health insurance premium, they do not have coverage. This is a very important number. According to the New York Times on February 13, 2014, about 20 percent of people who signed up by the beginning of this year never paid their January premium. One industry analyst reported anecdotal evidence that an additional two to five percent failed to pay their second month’s premium. A recent McKinsey & Company survey found that just 53 percent of previously uninsured people who selected a plan actually paid their first months’ premium. The payment rate was significantly higher – 86 percent – among people who were previously insured. Clearly the Administration’s enrollment numbers – already suspect – could fall in the coming months.

Administration Has No Clue How Many People Are Newly Insured. The Administration falsely boasts that more than nine million people gained health insurance coverage due to Obamacare. But it still hasn’t clarified how many of those people simply renewed coverage, switched from one private plan to another, or would have qualified for Medicaid without Obamacare. McKinsey estimated only 27 percent of people who signed up for Obamacare by early February were newly insured. Even this number is just an approximation – HHS doesn’t even see a need to track the one metric Democrats said they passed the health care law to improve. At an insurance industry policy conference this week, outgoing director of the Center for Consumer Information and Insurance Oversight at HHS, Gary Cohen, was asked how many of the 4.2 million Obamacare enrollees were previously uninsured. His shocking answer: “That’s not a data point that we are really collecting in any sort of systematic way.” Apparently the bureaucrats who created the Obamacare online application form didn’t think to ask people if they currently have insurance or ever had it in the past.

Monthly Reporting Tallies Still Contain Duplicates. The HHS report concedes that some state exchanges continue to have data problems that may have resulted in HHS double-counting certain sign-ups. This is not an insignificant figure. Approximately 38 percent of Obamacare’s total sign-ups are derived from the 15 state-based exchanges. HHS claims that HealthCare.gov’s sign-up data does not contain duplicates.

Health Care Headlines

Wall Street Journal: “Health Insurance Rates Likely to Rise in 2015” Health and Human Services Secretary Kathleen Sebelius said health-insurance premiums are “likely to go up” in 2015, an acknowledgment that the Obama administration doesn't believe the sweeping changes to the health-insurance marketplace will end premium increases in the near term.

Politico: “So how many have paid ACA premiums?” The White House insists it doesn’t know how many people are fully enrolled in Obamacare but insurers say they’ve handed over enough data to show that the sign-up numbers are not as rosy as federal officials say.

Washington Post: “Pace of health exchange enrollment slows in February, figures show” The pace at which Americans signed up for health plans slowed last month in the fledgling federal and state insurance marketplaces, according to new government figures showing that slightly fewer than 1 million people enrolled in February.

Reuters: “Insurers wary of Obamacare unknowns as they plan for 2015” U.S. health insurers are struggling to set prices for their Obamacare plans in 2015 and decide which regions to return to before the deadlines for submitting those plans to regulators.

New York Times: “Little-Known Health Act Fact: Prison Inmates Are Signing Up” Jails and prisons around the country are beginning to sign up inmates for health insurance under the health care law, taking advantage of the expansion of Medicaid that allows states to extend coverage to single and childless adults — a major part of the prison population. Although Medicaid does not cover standard health care for inmates, it can pay for their hospital stays beyond 24 hours — meaning states can transfer millions of dollars of obligations to the federal government.

Issue Tag: Health Care