7 million will be reached

Some important news on Exchange enrollment from the Health and Human Services blog:

Since the beginning of open enrollment, millions of Americans are gaining access to health coverage–many for the very first time—thanks to the Affordable Care Act. The most recent data indicates that approximately 3.0 million people have now enrolled in a private health insurance plan through the Federal and State-based Marketplaces since October 1.

This data strongly implies one million people enrolled for the February 1st coverage start date during the month of January.  That is a minimal pressure deadline as someone who was healthy enough to not get in on the December rush is probably healthy enough to not really need to get in on February. Procrastination is only so much fun.  I am projecting the same number of people will sign up for the March 1, 2014 coverage start date by February 15th.  That pushes the number to roughly 4 million private policies. 

The Massachusetts experience was that the greatest wave of enrollment was right before the hardest deadline when actual money was on the line.  We know there was a big flurry of older and probably sicker people signing up in December.  The young are entering the pools number, so getting an enrollment wave as large or larger than December for the March 15th deadline is highly probable.  And if that is the case 6.5 to 7 million people will be enrolled by April 1, 2014.  And then there will be the normal enrollment churn as people have different qualifying events that will put them on and take them off Exchange. 

 






46 replies
  1. 1
    aimai says:

    Thank you for this.

  2. 2
    srv says:

    All very good and well, but more people will buy Macintoshes this quarter than get healthcare.

  3. 3
    Belafon says:

    @srv: yeah, but I’m pretty sure there aren’t 200M Mac owners.

  4. 4
    LanceThruster says:

    I wonder if the MSM will treat Christie HGI Sandy money distribution failure the same way they did with the ACA rollout?

  5. 5
    aimai says:

    @srv: What on earth does that mean? I can’t even. People who buy Macintoshes are replacing something they already own with a freely available market commodity. People buying health insurance on the exchanges, or accessing it through Medicare, are being permitted to buy a scarce resource on a highly restricted market. More people will have dinner and breakfast this month than are getting health care. Its not a relevant observation.

  6. 6
    Violet says:

    Is there any ad campaign targeted toward young people using actual young people who have had an accident or illness and really wish they’d had health insurance. I know I’ve seen stories like that in the news but not ads.

    Something like a smiling gorgeous young woman who says, “My appendix ruptured. I had to have emergency surgery or I would have died.” Then she holds the hospital bill up to the camera and it’s something like $30,000 and she said, “If I’d had health insurance it would have cost me $700.” Then voiceover to “Get covered. It’s the smart decision.” Or something like that.

    Maybe a group of young men on their mountain bikes and one of them describes the wipeout one of the others had. “We were on the Gut Stomping Trail and Mike’s tire blew. (Mike nods) He wiped out and took Dave down with him. (Scene of bikes crashing, dirt flying) Dave’s leg was broken and he couldn’t get himself to the road. The ambulance guys had to come get him. (Dave holds up hospital bill) The whole thing cost $50,000.” Mike: “Dude, I told you to get health insurance.” Dave: “I should have listened to you.” Voiceover:” Listen to Mike. Get covered.”

    Real people in ads about their injury or illness. Young people. Is that happening?

  7. 7
    piratedan says:

    @Violet: have started to see some healthcare ads aimed at the recent college graduate crowd on various networks, mostly Discovery, Velocity, and USA networks, still don’t outnumber the Koch Bros. ad campaign about Obama’s Big Lie directed at congressional candidates but they keep swinging that hammer.

  8. 8
    Baud says:

    @srv:

    More people will buy toilet paper than Macintoshes this year.

  9. 9
    Bobby Thomson says:

    The latest Republican hostage has to do with cutting subsidies that would go to payors if the risk pool is a little too risky the first year. Any sense of whether your projections would make that a sleeves off the vest concession?

  10. 10
    ruemara says:

    @aimai: You have to ignore a progressive better. He’s communicating on a much higher plain than such plebian concerns.

  11. 11
    Mike E says:

    Hi, Richard, a quick update: I got my NC BCBS cards and celebrated by getting a flu shot, rapture. My dental plan said my spreadsheet info did not “link” from the market place, and I called healthcare dot gov to find out why…rep was just awful, not IT proficient nor customer service oriented, too. After the dreadful call ended with me changing my address and getting an FFE# to forward to the dental plan, I look forward to dealing directly with the providers. Will give further updates when I actually step into practitioners’ offices. Also.

  12. 12
    Mike E says:

    @Violet: Dunno about “sorry youngin’s” ads, but I did see one for healthcare dot gov where a college age/20something kid got a plan for $70.

  13. 13
    dpm (dread pirate mistermix) says:

    @srv:

    All very good and well, but more people will buy Macintoshes this quarter than get healthcare.

    The real tragedy is that some people will buy machines that run Windows 8 instead.

  14. 14
    aimai says:

    @Mike E: I presume that advertising is very situational–people say that in areas where insurance companies are marketing this heavily, they are marketing it heavily–they want younger customers and they will reach out to them. This has nothing to do with government at this point and I don’t think the system is necessarily set up for the government to spend its own scarce resources advertising to the youth market. But in other states, or on other sites/tvshows/media you are simply going to see insurance companies marketing to who they want as clients. They have a vested interest in getting clients to buy in so they will market to them–but you shouldn’t expect to see the young marketing thing unless you watch those tv shows or attend those colleges or read those magazines. It will be targeted.

    Here in MA where almost everyone was already covered the ACA revealed a complicated hole in the coverage applying to College Age kids who were being forced to buy higher priced college policies. That’s just been fixed at the legislative level. What I mean to be saying here is that some states are very pro-active and others of course are engaging in sabotage.

  15. 15
    The Very Reverend Crimson Fire of Compassion says:

    Sorry for the OT, but thought you all might enjoy noting that Dinesh D’Souza has been indicted for campaign finance violations. We now return you to your regularly scheduled thread.

  16. 16
    Mike E says:

    @aimai: My daughter’s cheap college plan seems spotty, tho it only has a $300 deductible. She’s thinking about applying for a market place plan, if either one of her parents can’t afford to add her to an existing plan.

  17. 17
    Cacti says:

    Medicaid enrollments have also been updated by HHS, with 6.3 million added since October 1.

  18. 18
    Bokonon says:

    This explains why the GOP is getting ready for a new, aggressive wave of national level sabotage efforts (like some more debt ceiling brinksmanship in Congress).

    Plainly, the state-level failures and chaos that the GOP created, and the bonfires they ignited (over the website issues, discouraging young people from enrolling, trying to scare older people over data security) haven’t done enough damage to slow down the larger successes of the ACA. They know the program isn’t failing – so it needs to be attacked and damaged some more.

  19. 19
    Lee says:

    @The Very Reverend Crimson Fire of Compassion:

    I’ve read that in multiple places today.

    I re-read it every time since i enjoy the story so much. Does that make me a bad person?

  20. 20
    Chris says:

    @The Very Reverend Crimson Fire of Compassion:

    I hate that guy. So I’m thrilled.

  21. 21
    wuzzat says:

    Does anyone here know anything about the NY Exchange? My dumbest cousin hasn’t signed up for insurance yet, partially because he’s afflicted with “government can’t make me do nothin'” stupidity, and partially because some friend of a friend told him he’s not eligible for subsidies, and won’t be able to afford it. This makes absolutely zero sense, since he works part-time for 17$/hr, is perpetually flat broke, is unmarried, and isn’t offered insurance through his employer, but NYS has done dumber things.

    The other apocryphal story I’ve heard about the NY Exchange is that they’re basing rates on your 2011 tax information and then hitting you with a big fee if the information has changed. Very Dumb Cousin was Very Unemployed in 2011, so this is also a potential pitfall.

    I live in MA, and am lucky not to have to deal with these shenanigans, but am interested about what, if anything, is going on over in NY.

  22. 22
    catclub says:

    @Bobby Thomson: If there was some evidence they were trying to make it better, then consider it. But I don’t think they are.

    They also are not really serious on this. If they break it this way, the first thing to get broken is shareholders of health insurance companies – not the ACA ( although it comes second). It is just a piced where they can yell “bailout”. They would be shocked if Obama agreed. ‘Yeah, lets screw the insurers’

  23. 23
    catclub says:

    @wuzzat: ” he’s not eligible for subsidies,”

    Might be true. half-time at $17/hr might make him eligible for Medicaid in that case.

  24. 24
    srv says:

    @Violet:

    Real people in ads about their injury or illness. Young people. Is that happening?

    Hot chocolate pajama hipster guy would own a Mac, but ObamaAd couldn’t connect the dots.

    @ruemara:

    The medium is the message.

  25. 25
    Violet says:

    @srv: He was an actor or model as far as anyone knew. No story to go with the pajamas, let alone a Mac.

  26. 26
    Higgs Boson's Mate says:

    @Bobby Thomson:

    The latest Republican hostage has to do with cutting subsidies that would go to payors if the risk pool is a little too risky the first year.

    Unable to repeal the ACA, the shit-for-brains Republicans will demonstrate their concern for America by attempting a Death by a Thousand Cuts strategy. As always, they’d rather have their country die for them.

  27. 27
    Higgs Boson's Mate says:

    @srv:

    Hot chocolate pajama hipster guy would own a Mac…

    Hot chocolate pajama hipster guy could fulfill all of his computing needs with a rig based on an Intel 4004.

  28. 28
    pat says:

    @The Very Reverend Crimson Fire of Compassion:

    Wow, the comments on that piece are nothing but It’s Obummer’s Revenge!!

    And they all believe that movie was wonderful and nothing but the truth about the nefarious usurper in the White House.

    Scary.

  29. 29
    srv says:

    @Violet: You are right to focus on messages targetted towards the one adult group that takes big physical risks.

    Maybe a google glasses view of handlebars poised at the top of a cliff, and checking an ACA checkbox with a response “Achievement Unlocked”

  30. 30
    The Red Pen says:

    Today’s wingnut-gasm is an article in Reason (fuck yeah!) is the Moody’s has downgraded the entire insurance sector because “Obamacare failed to sign up young people.”

    Researching rebuttal.

  31. 31
    ruemara says:

    @srv: your “message” is squat.

  32. 32
    Tommy says:

    @aimai: I used to live in DC and work for an ad agency that did work for a plan that was part of the Federal government health care plan(s). There was open enrollment each year, and we spent millions in the course of a few months. We always, and it wasn’t my account, promoted wellness. We wanted the younger people to enroll. I recall the most effective ad we did, bought throughout the city, was of an African American women, nude from the waist up, cupping her breasts with a headline about the importance of self breast exams. Their phone rang off the hook.

  33. 33
    Tommy says:

    @aimai: I used to live in DC and work for an ad agency that did work for a plan that was part of the Federal government health care plan(s). There was open enrollment each year, and we spent millions in the course of a few months. We always, and it wasn’t my account, promoted wellness. We wanted the younger people to enroll. I recall the most effective ad we did, bought throughout the city, was of an African American women, nude from the waist up, cupping her breasts with a headline about the importance of self breast exams. Their phone rang off the hook.

  34. 34
    Tommy says:

    @srv: That is one audience. But another as an ad guy is just wellness.That you can get a breast exam. Or the pill. Or for men just a basic check-up. Heck promote dental and vision coverage. IMHO a good worker is a healthy worker. So firms ought to promote basic healthcare. If they offer insurance, which I think all should, they ought to push their workers to use said healthcare. I know the places I worked at did.

  35. 35
    craigie says:

    @Higgs Boson’s Mate:

    Very true. Most people have all the compute power they need right there in their dishwasher control panel.

  36. 36
    Ernest Pikeman says:

    @Baud:

    More people will buy toilet paper than Macintoshes this year.

    Aaand they get more enjoyment out of their purchase!

    (Applephobe? Me? What makes you think so?)

  37. 37
    zamphuor says:

    @wuzzat: I’ve helped 4 people sign up for individual plans on the NY exchange. If your cousin makes less than 400% of poverty level (about 44K if single), he will be eligible for some subsidy. If his income is under about $15,100, he’d be eligible for medicaid.

    One person makes about 22K, and was able to buy a silver plan for $89/month. Another makes about 16K, and bought a silver plan for $42/month.

    Basically, it will tell you how much subsidy you are eligible for, based on your prediction of what you will make in 2014. If that amount is substantially different from your last tax return, a pop-up will say that, and ask you to select from a list of reasons why you believe your income will change (ie: changed jobs, more hours, etc.)
    If your income ends up being more than you claimed, you may be responsible for paying the difference between subsidy levels, but the website is clear about that. The NY exchange site is newyorkstateofhealth.ny.gov

    Hope this helps.

  38. 38
    thatguy says:

    Saw reference to a WSJ article last week that claimed that most of the exchange enrollees were replacing canceled coverage and are not “new?” Richard, any idea if the numbers you cite are gross or net of cancellations (and yes I understand there are always cancellations but I think reasonable people can agree there were more than usual the last months of 2013?).

    Would love to hear what you know on this. Genuinely curious.

  39. 39
    J.D. Rhoades says:

    @catclub:

    I’ve heard people bitching about the cost to them of “Obamacare” because they’re only working part time for min. wage and can’t afford to buy on the exchanges. When I point out that they may be entitled to Medicaid (even though NC hasn’t accepted the expansion), they complain that Obamacare’s driving them to be on welfare.

  40. 40
    aimai says:

    @thatguy:

    I can’t answer for Richard but as I understand it there are a few different kinds of people who “had coverage” that “was dropped” before the ACA went into effect: people who had junk insurance but were not aware of it or not aware that there was an alternative, people who bought expensive policies that didn’t really cover much and which don’t conform to the new standards, and people with pre-existing conditions who couldn’t buy coverage before or were in various high risk pools which are being phased out. Even within those categories the people who bought junk insurance or catastrophic insurance usually are churned up and out of the system on a regular basis.

    So: some portion of people, maybe even a lot of people, who have enough money to qualify to buy on the exchanges (are not automatically put into medicaid or medicare or covered by their employers) were actually, technically, “previously insured” but that would have been true on the individual market anyway. People were shopping around before the ACA, but with less leverage.

  41. 41
    Stella B. says:

    @wuzzat: what Zamphuor said. Also, too, your cousin will be eligible for cost sharing to cover co-pays, etc.

  42. 42
    GregB says:

    So the Republicans are going to make kicking 10 plus million people off of insurance the focus of their 2014 campaign?

  43. 43
    Ruckus says:

    @GregB:
    Would you expect anything less?

  44. 44
    wuzzat says:

    @zamphuor: That’s very helpful, thank you, and it lines up with how I thought the exchange worked, but sometimes living in MA makes me that cowgirl who gets her salsa from New York City as far as the relatives are concerned.

  45. 45
    tominwv says:

    These data strongly imply…

  46. 46

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