Whats in a number

President Obama’s press conference this afternoon threw out a series of numbers concerning interest in subsidized health insurance on the Exchanges.  What do these numbers actually mean from an insurer’s perspective?

So far, the national website, HealthCare.gov, has been visited nearly 20 million times.  Twenty million times.

This means very little.  For comparison’s sake, Balloon Juice has had slightly less than 10% of that traffic in the same time span.  These hits are not particularly informative as they could be the curious bloggers, they could be people who are looking and then walking away, and they could be people who are interested.

We know that nearly one-third of the people applying in Connecticut and Maryland, for example, are under 35 years old.

If these numbers hold up and can be nationalized at scale, then the financing of the Exchanges works out very easily.  I am slightly curious as to why these two states are examples as the demographic/actuarial concerns are national lack of interest in young people in these products.  I would love to see what the age profiles look like in California (as it is the biggest), Texas, and Kentucky look like.

  And all told, more than half a million consumers across the country have successfully submitted applications through federal and state marketplaces.

The actual number is 476,000 or more applications have been submitted for eligibility verification.  This is an important number.  These are the subscribers who have created an account, filled out the first round of applications with family size, birth dates, and income information and sent it in for verification.  A very high percentage of these applications will result in added medical coverage.  The question is what is the average number of people on an application and what is the conversion rate to Medicaid versus Exchange.  As an insurance geek, 476,000 applications indicates 476,000 potential contracts, and probably 800,000 or more actual covered lives.  Initial numbers out of states indicate a 40% to 50% Medicaid eligibility rate, so assuming a fairly high buy rate for Exchange eligible applicants, we’re looking at 5% to 7% of the Exchange goal population has already applied.

Trained representative, it usually takes about 25 minutes for an individual to apply for coverage, about 45 minutes for a family.  Once you apply for coverage, you will be contacted by email or postal mail about your coverage status.

That actually is really impressive for initial intake and application.

Right now, the enrollment numbers are low as insurers don’t consider someone enrolled until either the check has been received or the credit card swiped for the first month’s premium.  January 1st is the first day of coverage, and payment is not due until Dec. 15th, so quite a few people are making choices and getting in line to get on a plan but have not written the check or authorized the automatic charge against the credit card.

42 replies
  1. 1
    Fluke bucket says:

    Threw rather than through but I absolutely LOVE what you bring to this site.

  2. 2
    Yatsuno says:

    One minr nitpick: very few credit cards will get swiped. Instead they will give the numbers and the CCV code and just let the payment process electronically. This information will most likely be used for the premium information as well. What I’m curious about is someone who gets a rather large subsidy who then doesn’t hold up their end of the premium. What exactly is the cutoff point where they are no longer insured? And does that make them eligible for the (totally wussily enforced*) fine?

    *Yes this is personal. I want the ability to actually GET these idjits who want a free ride in the ER!

  3. 3
    jibeaux says:

    @Yatsuno: I have a feeling if you don’t make your monthly payment, you will probably be dropped within that same month. BCBS of NC wants its premiums for the upcoming month paid by the 1st and they advise that they will drop you if not received by the 15th.

  4. 4
    sparrow says:

    Excellent post as usual. Through –> threw, though.

    And sorry to get all OT, but this story about a shooting rampage in a MIDDLE school was buried under three other articles on huffpost. Wtf?



  5. 5
    Yatsuno says:

    PS: Google Doodle. AWESOME!!!

  6. 6
    Richard Mayhew says:

    @Fluke bucket: Thank you and homonym has been updated. I am notorious for using the wrong homonym all the time.

  7. 7
    Richard Mayhew says:

    @Yatsuno: Here is the relevant scenario.

    If a person never pays the first month’s premium, they don’t get any coverage.

    If a person pays the first month’s premium on time, they get coverage on the 1st of the following month. Now if they never pay again, the following happens.

    1) They get full coverage for the month that they paid for.
    2) The insurance company is responsible for all incurred expenses in the next month (the first month of late payments)
    3) The providers eat the costs for days 31-90 after missed payments.

    The entities in #2 and #3 can go after the assets and income of the individual who stiffed them for medical expenses.

    If the scenario is that an individual makes the first payment on Dec. 15, misses the January 15th payment, but makes a double payment on Feb. 15, they are even and good to go.

  8. 8
    Fluke bucket says:

    @Richard Mayhew: you are welcome and once again the education I am getting from your posts is so very much appreciated.

  9. 9
    Mike in NC says:

    But Turtleman says ACA is a ‘train wreck’ and worse than a visit to DMV. But everywhere I’ve lived in the past 25 years the DMV has actually been pretty damn efficient. So Turtleman’s just a clueless hack and asshole. But we already knew that.

  10. 10
    Yatsuno says:

    @Richard Mayhew: Working where I do, this is of interest to me. Payments get lost, they get posted to the wrong account, they get written on the wrong check, and any other myriad scenarios. I think putting the responsibilty for collection on the insurers is a better idea since they will become the actual POC for any issues. This will NOT keep the government from getting these calls. Hell I anticipate a few and my agency is only collecting the fine.

  11. 11
    jenn says:

    @sparrow: I know. It’s been pretty much ignored here at BJ today, too, unfortunately. I feel so lucky to have grown up in a time/place where all I needed to worry about were the mean girls, not getting shot.

  12. 12

    @Mike in NC: Eh. Try the DMV down by Leisure World at 7AM – also known as ‘lunch hour’ for that set, apparently.

  13. 13
    jibeaux says:

    @Richard Mayhew: Well, sure, if you want an INFORMED opinion.

  14. 14
    Violet says:

    From the Newsmax headlines in the side column:

    Consumer Reports Tells Readers: Avoid Obamacare

    I’m not going to click on it, but wonder what small nugget of truth they twisted to create that headline.

  15. 15
    Hill Dweller says:

    @Violet: Consumer Reports has already released a statement and sent out tweets calling the wingnut talking points “distortions”.

  16. 16
    Flying Squirrel Girl says:

    I’d like to relate my experience: I was patient and worked my way through the process; it took probably 5 visits to accomplish, and the website wasn’t always cooperative. But as I said, I was patient. I live in Texas and understand that, being thrown onto the federal exchange because of GOP obstructionism, the system was overloaded precisely because of assholes like Rick Perry and his colleagues in 20-something other states…

    I do not qualify for a federal subsidy. I am single, 35-45, nonsmoker. I was offered 39 plans and have narrowed it down to 2. They are silver-level coverage, and are $260 and $316 depending on deductible.

    When I worked as an HR director in 2007, we offered coverage to our employees that was covered by the company at $260 per month. SIX. YEARS. AGO.

    I’m quite pleased with the rate quotes I received.


  17. 17
    CTVoter says:

    @sparrow: Kids got shot dead. Today. But it was a middle school. Margin of horror not so bad as an elementary school shooting. Since Sandy Hook Elementary? The margin of horror is now ….more than a couple of kids getting shot.

  18. 18
    max says:

    If these numbers hold up and can be nationalized at scale, then the financing of the Exchanges works out very easily. I am slightly curious as to why these two states are examples as the demographic/actuarial concerns are national lack of interest in young people in these products. I would love to see what the age profiles look like in California (as it is the biggest), Texas, and Kentucky look like.

    I am going to bet that it’s because Connecticut and Maryland have state-run exchanges, and those exchanges are functional.

    While checking my intuition, Great Google coughed up this:

    Like the District, Maryland, Connecticut and Oregon took on the task of creating exchange themselves, rather than leaving it to the federal Department of Health and Human Services and its much-maligned contractor, Reston-based CGI Federal. Delaware’s exchange is a partnership that left a lot to the feds, but still demanded real attention and buy-in from locals.

    Obama didn’t mention the District, but there’s a pattern emerging here. Like the state-run exchanges, the D.C. Health Link has not been perfect, but it has been generally functional. After I created an account in the morning of Oct. 1, I’ve gotten two mailings from relevant agencies processing me.

    And also the winger-tilted version, ‘Big insurers avoid many state health exchanges’:

    Many state-run exchanges also have far fewer than HHS’ average, which is weighted based on the number of uninsured residents in an area. Vermont has two, Kentucky has three and Nevada and Maryland each have four.

    Some insurers pulled out of the exchanges required by the Affordable Care Act as the Oct. 1 launch approached. That leaves an uneven patchwork of providers — ranging from one insurer in New Hampshire and West Virginia to 16 in New York.

    Probably want a regional exchange for New England at some point.

    [‘Will moderation consume this post? Stay tuned to the same Bat Channel to see!’]

  19. 19
    Ken says:

    @Mike in NC: But Turtleman says ACA is a ‘train wreck’ and worse than a visit to DMV.

    Terry Pratchett once wrote something like, “There are three kinds of people in the world: those who see the glass half-empty, those who see the glass half-full, and those who start shouting ‘This cannot be my glass! I deserve a full glass! Waiter!’ ”

    I’ve noticed that the people who complain about the DMV tend to fall into the third category, and get even more angry because they have to wait in the same line as everyone else instead of being treated with the special deference which they so clearly deserve.

  20. 20
    askew says:

    @Mike in NC:

    But Turtleman says ACA is a ‘train wreck’ and worse than a visit to DMV. But everywhere I’ve lived in the past 25 years the DMV has actually been pretty damn efficient. So Turtleman’s just a clueless hack and asshole. But we already knew that.

    I’ve been to the DMV in 4 different states and always found it to be pretty efficient as well. Never understood that comparison.

  21. 21
    Villago Delenda Est says:

    Noisemax headline: Dick Cheney: Tea Party ‘Good Thing’

    In other news, Lord Voldemort declares the Deatheaters to be a “Good Thing”, and Saruman declares the Uruk-Hai to be a “Good Thing.”

  22. 22
    Hungry Joe says:

    Horrorshow at the DMV — government at its worst — is, in my experience, a canard. In California a couple of decades back it was a light to moderate pain in the ass, more trouble than it should have been but not all that bad. In recent years it’s been a semi-breeze. It’s a complex, gargantuan enterprise charged with serious responsibilities, yet things run pretty smoothly.

    Still, every time I go I hear people muttering about government ineptitude because they have to wait in line 12 minutes to take their eye test.

  23. 23
    jenn says:

    @CTVoter: Seriously?! A teacher is dead and 2 students are shot, and that doesn’t rank as horrible in your book? As if the shootings weren’t bad enough, I’m finding the non-reaction by, well, pretty much everybody, further dispiriting.

  24. 24

    Slight tangent – did anyone catch John McAfee on Cavuto talking about security issues with healthcare.gov? I just read that Republicans want him to consult about what went wrong with the rollout…

  25. 25
    Higgs Boson's Mate (Crystal Set) says:

    Americans have been waiting decades for affordable health care. Now some of them are getting upset because it takes some minutes to apply for affordable healthcare. WTF?

  26. 26
    TG Chicago says:

    Related, I was surprised by this from the Newsmax headlines:

    Consumer Reports to Readers: Avoid Obamacare

    I checked it out, and of course that headline is highly misleading. All CR says is that given the problems with Healthcare.gov, they recommend you wait another month before checking out the site.

    Really, I’d say that headline is misleading enough that you can go ahead an call it an outright lie.

  27. 27
    Ruckus says:

    @Higgs Boson’s Mate (Crystal Set):
    Must be the folks that pass me in their full size SUV’s at 90 on the freeway, talking on the cell. Get out of my way, I might be late for my Starbucks hit!!! I have the gold package, can’t you see I’m impotent!!!

  28. 28
    Ruckus says:

    @Knight of Nothing:
    I keep hearing that John Mc is a criminal. If that’s so then he would fit right in with rethugs.

  29. 29
    Chris says:

    @TG Chicago:

    That’s fucking blatant.

    Liberal media FTW.


    “Is there a VIP entrance? We’re VIPs.”

  30. 30
    Mark B. says:

    @Knight of Nothing: seriously? John McAfee? Don’t they know the man went off the deep end about a decade ago and is now a drug-addled freak? I’m surprised they were able to clean him up enough to get on television. That guy at one time had hundreds of millions. I guess a whole lot of it went up his nose.

  31. 31
    Mark B. says:

    @Mark B.: Here’s a recent article about McAfee. He is not, and never has been a white knight. http://www.wired.com/threatlev.....12_mcafee/

  32. 32
    Villago Delenda Est says:


    Just another day in the land of firearms freedumb.

  33. 33
    pseudonymous in nc says:

    I do think that one of the issues here is that a relatively small number of people have applied for individual health insurance online, and so comparing it to buying a widget on Amazon isn’t the model here.

    This doesn’t stop healthcare.gov from being an IT shitshow — because, really, it is, and it needs to be the cue for a wholesale change in federal online service delivery — but it’s a closer transaction to filing a tax return than buying a widget.

  34. 34
    mai naem says:

    @Knight of Nothing: JC Christian has a tweet today about this that gave me a laugh, something to the effect “You want the guy who shoves bath salts up his ass to consult on healhtcare IT?”

    Hey, Richard, I also appreciate your posts. You’re a wealth of info. Arizona has a coop. I have looked at the exchange before and didn’t realize it was a coop. Anyhow what’s your opinion of coops? I remember hearing a story on one in the Pacific NW that was working pretty good. Anyhow, this one’s called Meritus.

    Also too, the $476K is only the fed exchange. The state exchanges are additional right?

  35. 35
    Manyakitty says:

    Are those hits individuals or repeat visitors trying to establish an account. Of course, beautiful Ohio chose not to set up a state exchange, so I’ve been fighting to make the federal one work. I have insurance through my employer right now, but that is likely to change when our contract expires in March. I got through the email authorization, but still can’t log in to my account.

    Related to my situation, though, is there any word about how/if the SHOP exchange is working? That’s going to be the key for me to keep employer-funded health insurance. So far, I don’t know whether my employer has been able to access it or not.

  36. 36
    Regnad Kcin says:

    @max: Regional exchanges == first step down the road of untying ourselves to the Taker States. First regional health exchanges, then regional block grants (equalizing transfer payments within the region, instead of shipping $$$ off to Griftistan)

  37. 37

    @mai naem: that’s hilarious! I actually had a similar reaction, though not nearly as good a punchline. Stealing.

    Even though JMcAfee is a tool, I don’t know anything about the technical design or the performance issues with healthcare.gov, so I was wondering if there was anything to his analysis.

  38. 38
    flukebucket says:

    @TG Chicago: Newsmax knows all too well that their readers see the headline and that is all they will ever see. Suddenly thinking people are left to play whack-a-mole with the Consumer Reports says Obamacare doomed meme.

    My all-time favorite Newsmax bait is the picture of Jesus looking like He is lost at a parade with the headline reading, “Will He Ever Return?” LOL!

  39. 39
    Kirbster says:

    The crux of the problem is that after 224 years the large entity in the middle of the North American continent has yet to decide whether it wants to be “united” or “states”. One reason the ACA rollout has been so complicated is that there are 50 different implementations of the new law. The “Hey! Let’s reinvent the wheel fifty times with fifty different sets of insurance providers with wildly variable rates!” quality of the thing ought to make seniors on Medicare leery of what may be in store for them if the GOP gets to transform Medicare into a “coupons for codgers” program that throws them back into the open healthcare insurance market.

  40. 40
    LanceThruster says:

    476,000 new names for the Death Panels


  41. 41

    The exchange rollout is depressingly bad, however. Government programs do need to be marketed, just like commercial products, and this looks very bad, especially to younger people. When one considers how competent the Medicare and Social Security administrations are it’s discouraging how badly this has gone.

  42. 42
    PopeRatzo says:

    I don’t have a good reason to believe President Obama. We’ve got like two months to get at least 7 million people, and a whole lot of them better be healthy young’n’s who don’t want health insurance or we have a problem.

    The website shitting the bed after the time and expense that has gone into it makes me very uncomfortable. And as of today, the 800 number is still referring people to the website.

    Just cover everyone, for chrissake!

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