As of last week, fewer than 50,000 people have signed up for private health insurance on the federal government’s exchange, the Wall Street Journal reports — specifically, health-insurance companies have gotten the health-plan enrollment information for 40–50,000 people. Internal memos cited by Michigan Republican congressman Dave Camp last week had projected 500,000 enrollees on the federal exchange (which serves about 35 states) through October, so obviously the target has been missed by a wide margin. The federal exchange has also presumably led many people to sign up for Medicaid, but we don’t know how many just yet.
This number, by my ballpark calculations, means about 1 percent of the people whom the CBO expected to enroll on the federal exchange have purchased plans so far.
This is worse than the enrollment numbers seen in states that are running their own exchanges, which have supposedly been more successful (some of them do still have to rely on federal resources, such as the federal “data hub” that verifies people’s eligiblity for tax credits), but not much worse. Avalere, a health-care consulting firm, released an estimate today based on publicly available information that about 50,000 people have enrolled in private health-care plans, which amounts to, by their reckoning, 3 percent of the people expected by the CBO to enroll in those states for 2014 (based on the CBO’s national estimate of 7 million).
Doing some back-of-the-envelope math with Avalere’s model, about 2.5 million of the people the CBO expects to get insurance live in states with state-run exchanges, leaving 4.5 million in the states with the federally run exchange –so about 1 percent of the people who need to enroll have enrolled. This is a really rough estimate, of course, but it is interesting — it’s a poor showing (the Obama administration expected 10 percent of the target enrollees to sign up in this time period, according to the aforementioned documents), but it isn’t much worse than the state exchanges, either.
Sliced another way, working just from the numbers of uninsured people in each state (regardless of income and subsidy eligiblity, etc.), the rate is similar. About 60 percent of uninsured Americans live in states using the federal exchange, so we’d expect about 4.2 million of them to get insurance — again, meaning about 1 percent of the CBO’s projected enrollees have enrolled.
Some context for the numbers is warranted: People don’t need to enroll until mid December for their coverage to begin January 1, and they don’t need to enroll until March 31 to avoid the individual-mandate penalty, so one wouldn’t necessarily expect them to be banging down the door yet. Avalere points out that only 10 percent of eventual enrollees in Medicare Part D did so by the time coverage began (January 1, 2014 being the equivalent date here). And the White House also likes pointing out that enrollment in Massachusetts’s exchanges went even slower, with just 0.3 percent of enrollees in the first month. But there, residents had eleven months to sign up between the debut of the law and the mandate’s deadline; automatic enrollment of some uninsured not counted in the 0.3 percent number also proceeded much more rapidly (the only automatic enrollment for Obamacare involves some states transferring people from state-level insurance programs to Medicaid).