August 9, 2022

Report: Less Than 15 Percent of Obamacare ‘Enrollees’ Are Actually Covered


This week’s Obamacare headlines have been dominated by HHS’ announcement that 365,000 Americans have selected a plan through Obamacare’s federal and state exchanges — well short of the administration’s projected goal of 800,000 enrollees by December 1st. Allahpundit explains why that government’s official number is misleadingly high:

Three huge caveats to the 365,000 figure. One: As Phil Klein notes in the excerpt, by HHS’s own admission, some of them are duplicates. And the fact that they felt obliged to admit that in a report that they’re desperately trying to spin as good news suggests that “some” isn’t an insignificant number. Two: As you hopefully already understand, “sign-ups” aren’t the same as “enrollments.” HHS’s original targets for O-Care were based on the assumption that people would be fully enrolled with their new insurers and ready to go with coverage on January 1. But because they’re desperate for positive publicity, they tweaked that metric so that anyone who’s tried to sign up and gotten as far as choosing a plan, even if they haven’t actually purchased it yet, counts in terms of them hitting their target. The actual number of people who’ve enrolled, not just “signed up,” is a well-kept secret. Three: As you also know by now, even if you’ve pulled the trigger on a plan and enrolled with an insurance company, your enrollment isn’t valid until you’ve paid your first month of premiums.

The duplication issue is part and parcel of the 834 error rate snags that continue to plague’s back end. The “selected a plan” verbiage is a flat-out trick, which we’ve discussed many times. Obamacare administrators are counting people who’ve browsed the website and placed a plan in their virtual shopping cart — but who never finished the process by checking out — as “enrolled.” That’s a bogus metric. It’s even more bogus when you recall the last point in bold. People are not covered unless and until they’ve made their first premium payment. I’ve made this point before, which Kathleen Sebelius helpfully reinforced during Congressional testimony on Wednesday:

Rep. Michael Burgess (R-TX): What if that patient doesn’t make the premium payment? You said they’re covered Dec. 23, but they never write the check. They never make the payment.

Sebelius: Then they’re not covered. They are not enrolled, and at every point along the way, on the website they are told until they make the payment—

So far more important than HHS’ raw, ginned-up enrollment figures is the composition of that pool. First, are enough new sign-ups coming from so-called young invincibles? Early clues aren’t looking promising, and the White House’s radio silence on this point is the most damning evidence of all. If the risk pool looked healthy, Obama and Sebelius would be shouting it from the rooftops. Instead, they’re saying nothing (probably because they can see the data that backs up this assessment). And second, how many of these “enrollees” have made the requisite payments to guarantee coverage starting in January? That’s been another mystery, with one small (and worrisome) data point emerging last week. Now we’re getting more information on this question, and if industry sources’ estimates are even close to accurate, they foretell another Obamacare catastrophe. Via lefty journalist Charles Ornstein:

“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 that around 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. “It naturally varies by insurer and will hopefully increase as we get close to end of December and documents flow in the mail,” added Piper, a former official at the Centers for Medicare and Medicaid Services. “But overall I’m hearing it’s a small portion so far. And that, of course, is a fraction of an already comparatively small number of people who have made it through setting up an account, getting verified, subsidy eligibility determined, plan selected, complete and correct data transferred to the insurer, and insurer set out the confirmation with invoice for consumer’s share of the first month’s premium.”

A fraction of a fraction. This is devastating news, piled atop similar “enrollment” confusion involving people who think they’ve signed up for Medicaid through Obamacare, but whose applications are stuck in transaction error purgatory. Allahpundit wonders why the administration isn’t freaking out about this disaster, concluding — probably correctly — that they’re playing politics. They know they’re in deep, deep trouble, and have decided not to call attention to it. Their PR mess is bad enough as it is. Once a bunch of Americans start to realize they’re not actually covered in January, Sultan Obama will decree some additional extra-legal “fix” to temporarily patch over the problem. Then again, his previous on-the-fly improvements haven’t necessarily made realities on the ground any better. January is going to be a rough month for a lot of unsuspecting people. I’ll leave you with with a graph from American Action Forum. It charts the first two months of Obamacare enrollments, compared to both Medicare Part D’s sign-up rate and the White House’s expected trajectory for Obamacare:


Bear in mind that the gold line is based upon HHS’ inflated figures. For reasons explained above the real ‘actual’ numbers are almost certainly much, much lower.