The Obama administration has released a report detailing the enrollment numbers from the first enrollment period. Note that these numbers are still incomplete, as final enrollments were still trickling in from the two week grace period given to consumers who had difficulty enrolling before March 31, 2014. The big number that has been bandied about is “eight million enrolled” citizens into Obamacare plans- but what does that number actually mean? Vox.com issued a nice summary at the link above.
The eight million figure comprises:
- Consumers who created a marketplace account on an exchange, whether federal or state, and enrolled in a health insurance plan
- “enrolled” in this case means “had their information sent to the insurance company
- Some percentage of these folks have not and will not pay for their premium- an estimated 10-15%, based on numbers recently released by AHIP– America’s Health Insurance Plans.
The figure does NOT include:
- Private enrollments made through carriers directly outside of the marketplace
- Medicaid enrollments
- Group enrollments
- Those young adults under age 26 who were eligible to enroll in their parents’ health plan
Attempting to calculate Obamacare’s true reach is extremely difficult. We can count who signed up for insurance, but we can’t determine who only signed up because the legislation caused them to lose their plan in the first place. We can count who signed up for Medicaid, but we can’t calculate who signed up that was newly eligible based on the new Medicaid expansion rules.
We will also see these numbers fluctuate throughout the “offseason” between open enrollments. Special Enrollment Periods, unlocked with major qualifying life events, will be used to move into marketplace plans even now that open enrollment has closed. Marriage, birth, adoption and especially job loss are common triggers of Special Enrollment Periods. The individual health insurance industry always had some degree of turnover, much of it attributable to consumers getting new jobs and leaving the individual market to join their employer-sponsored group plan. The same will continue under the ACA, as will the reverse scenario of consumers leaving their jobs with employer-sponsored plans and entering the individual market, as the lack of pre-existing condition exclusions will allow free movement between group and individual programs. These “final” enrollment numbers released by the administration are anything but.