Obamacare 'enrollees' not really fully enrolled
Last week, the administration put on their happy faces and announced that 1.2 million people had signed up for Obamacare through state exchanges and the Obamacare website.
More than 800,000 were new Medicaid patients who will likely be looking for a doctor - any doctor - to treat them. But around 365,000 have completed the sign up process for private insurance.
But does the fact that they've signed up mean they're officially "enrolled" in the program?
HHS is boasting of enrollment for November that was four times as high as October, yet 62% of the total was in the state exchanges, some of which are marginally less prone to crashing than the federal version. Then again, 41 states posted sign-ups only in the three or four figures, including eight states that run their own exchanges. Oregon managed to scrape up 44 people. Among the 137,204 federal sign-ups, no state is reaching the critical mass necessary for stable insurance prices.
The larger problem is that none of these represent true enrollments. HHS is reporting how many people "selected" a plan on the exchange, not how many people have actually enrolled in a plan with an insurance company by paying the first month's premium, which is how the private insurance industry defines enrollment. HHS has made up its own standard.
Insurers know that the hardest part of doing business in the individual market is getting customers to write a check. People are accustomed these days to automatic payroll deductions and the unseen lost wages of employer-sponsored insurance. Many Americans may enroll on the exchange but then fail to pay once they see monthly costs that could range from the equivalent of a cellphone bill if they qualify for subsidies (President Obama's favorite comparison) to premiums that can exceed $1,000 or huge deductibles for the unlucky who must overpay to finance the insurance of others.
So just how many people have completely "enrolled" in Obamacare?
But amid the rush to enroll as many people as possible by the Dec. 23 deadline, there's a huge caveat that isn't getting much public attention: In order for coverage to take effect on Jan. 1, enrollees must pay their first month's premium on time. (The deadline varies somewhat by state and by insurer.)
That's slow going, according to consultants and some insurers, raising the prospect that actual enrollment will be far lower than the figures HHS is releasing.
"There is also a lot of worrying going on over people making payments," industry consultant Robert Laszewski wrote in an email. "One client reports only 15% have paid so far. It is still too early to know for sure what this means but we should expect some enrollment slippage come the payment due date."
Another consultant Kip Piper, agreed. "So far I'm hearing from health plans thataround 5% and 10% of consumers who have made it through the data transfer gauntlet have paid first month's premium and therefore truly enrolled," he wrote me.
Even at 15% paid enrollments, that represents a little more than 50,000 Obamacare policies. The administration says it needs 7 million by March 31 with 2-3 million of those policies bought by the young, healthy segment of the market.
We are headed for some kind of crash, meltdown, clusterfark - call it what you will. What seems certain is that more people are going to be uninsured as a result of Obamacare than will be enrolled in the program - the exact opposite of why the law was passed in the first place.