Do we know real Obamacare enrollment numbers?

It’s not unreasonable that the Administration tries to put Obamacare enrollment in the best light, but the numbers are different from different sources and depending on the month of the year. 

Many people enroll, but never pay premiums so enrollment is revised later in the year. 

20 million is a frequently thrown around number, but what you don’t often hear is that the majority of that number excluding the adult children, is from Medicaid expansion. 

You also don’t hear that adult children were typically covered to age 23 and in some cases 25 or that the majority of new Medicaid enrolled were eligible before Obamacare.  

This report estimates that 20.0 million uninsured adults have gained health insurance coverage because of the Affordable Care Act as of early 2016. This includes:

😷17.7 million nonelderly adults (ages 18 to 64) who gained health insurance coverage from the start of Open Enrollment in October 2013 through early 2016.

😷2.3 million young adults ages (ages 19 to 25) who gained health insurance coverage between the enactment of the Affordable Care Act in 2010 and the start of the initial Open Enrollment Period in October 2013 due to the ACA provision allowing young adults to remain on a parent’s plan until age 26.

Source: HHS report November 2016

Federal health officials Wednesday touted a record 6.4 million customer sign-ups on the federal Obamacare marketplace so far this open enrollment season — topping last year’s pace during the same time period by 400,000 customers. Source: CNBC

6.4 million more, 6.4 million including re-enrollments and new plan selection?

Eleven plus million, so enrollment has increased by two million during one open enrollment or is it 1.5 million and what will it be when we know who actually paid their premiums?

CMS press release January 10, 2017

A new report released today by the U.S. Department of Health and Human Services (HHS) shows that more than 11.5 million people nationwide were signed up for Health Insurance Marketplace coverage as of December 24, 2016, an increase of 286,000 plan selections relative to the comparable period last year.


4 replies »

  1. One of the worst provisions in the ACA is coverage of adults between 22 and 26 under their parent’s plan. Young adults earn less just starting out in life. A low premium – high deductible plan would be appropriate for most of them. The result: boosted premiums for everyone to pay for those who had adult children under their coverage. Apparently the Republicans want to keep this.


  2. I would also note that enrollment has slowed – and is significantly below initial projections:
    2014 – predicted exchange enrollment growth – 8MM, actual enrollment growth 6.0MM
    2015 – predicedd exchange enrollment growth – 5.0MM, actual enrollment growth 3.1MM
    2016 – predicted exchange enrollment growth – 8.0MM, actual enrollment growth 1.3MM

    That is, the increases in the individual mandate penalty tax did not have their anticipated effect of driving enrollment – in large part because the government adopted a plethora of exceptions, and waived many of those penalties.


  3. “Open enrollment” runs through January 31, 2017. Data on who actually paid premium won’t be known until April 2017. Medicaid, with some exceptions, is non-contributory. So, when the states/feds report Medicaid numbers, that is probably close to being accurate on that date – only in terms of enrollment, not in terms of increased enrollment due to Health Reform. There is this little thing called the economy – that also drives enrollment.

    Enrollment will vary throughout the year. So, I would look at exchange enrollment no earlier than April – and compare April over April, year over year, to take the noise out.

    In terms of Medicaid, government data show:

    Increase in Medicaid enrollment from 3rd quarter 2013 to April 2016
    States that expanded Medicaid 13,300,130
    States that did not expand Medicaid 2,384,358
    Increase in Medicaid enrollment 15,684,488

    Even my 27 year old daughter signed up for Medicaid in 2014 (when she qualified) – free stuff!!!!!

    In the federally-administered exchanges, 2016 enrollment after the end of open enrollment (before all had to pay a premium) was: 9,625,982 of which 8,183,059 received subsidies or 85%. Chances are that most of that 85% will continue – more free (or at least subsidized) stuff!!!
    Kaiser reports total 2016 enrollment at the end of the open enrollment period of 12.7MM – meaning 3 million enrolled in states where the state administers the exchange. Again, these data do not reflect those who dropped coverage because they didn’t pay the premium.

    So, the Medicaid data are not reported separately for health Reform’s expansion in eligibility – versus growth because of our crappy economic conditions. So, for comparison, food stamp eligibility has declined from a high of 46+MM to 43MM as of September 2016, back down to 2011 levels, but only because some states re-implemented the pre-American Recovery and Reinvestment Act of 2010 (the stimulus) work requirement for able bodied adults without dependent children – more free stuff!!!!!

    Republicans’ problems are simple when it comes to “repeal and replace” – “repeal is easy, just starve the law for funds. “Replace” suggests something that Republicans will tout as better than the status quo. However, the media will measure “success” based on how many of those who gained taxpayer subsidized coverage as a result of Health Reform will maintain that coverage after “replace” By definition, just as was the situation with Health Reform, there will be millions of Americans who can’t “keep their plan if they like it” – even though that was president Obama’s promise, not the Republicans. Good luck with that.

    There always were better options to spur an increase in the number of Americans with coverage and to reduce the number of Americans who were uninsured. It should be noted that about 95+% of those who were uninsured in 2009 were not people turned away because they had a preexisting condition. Instead, almost all uninsured were not covered because they were not willing to shoulder the cost of health coverage, where about 70% of those who were uninsured actually had the financial means to purchase coverage, they just had different priority.

    So, Health Reform was NEVER intended to achieve 100% coverage, 0% uninsured. And, of course, Health Reform NEVER intended to achieve “affordability” for the vast majority of Americans – those who already had coverage under an employer plan, in the individual insurance market, in Medicare or Medicaid.


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