Let's take a peek at those enrollment numbers

The disastrous news related to Obamacare has been piling up so thick and fast that it’s hard to absorb one piece of it before the next arrives. Yesterday and today, the media was focused on the millions of people who have been kicked off their health insurance plans, Obama’s promise that such a thing wouldn’t happen, and his attempt to fix the problem. It’s seems bonkers that a mere two days ago, everyone was focused on a different piece of bad news: the amazingly low number of people who have enrolled in new, private insurance plans.

As many numbers were flying around, it may be helpful to present them all. 1,509,883 people are said to have filled out an application. Of those 1,081,592 were found to be eligible for private insurance. Many of the others would be eligible for Medicaid, and in states that have chosen the Medicaid expansion, a good-sized number have signed up for it: 396,000.

In the world of private insurance, however, the numbers are not so rosy. At total of 106,185 people have selected a plan. The Administration had predicted 500,000 would select a plan during the first month, and many other sources predicted an even higher number. So by any measure, that’s not good.

But it gets worse. “Selecting a plan” is not the same as buying a plan. No one seems to have nationwide data on how many people have bought plans, but there are some numbers from Washington D.C.: 321 people selected plans, 164 asked for an invoice on their plans, and a whopping 5 people have actually handed over money for a plan.

Of course, who knows how the nationwide numbers match up with DC’s? And whose knows how many of the people who have selected plans but not paid yet will eventually pay? I’d predict that in a few months, the number of people paying for private insurance in DC will be substantially higher than 5. But would you guess what the administration’s goal is for DC? It’s to enroll 43,000 people by March. So even if the eventually number for DC is a thousand or two thousand or three thousand times higher than what it is now, that’s still a huge shortfall.

That leads us to the next question: why aren’t people buying private health plans? It’s no secret that the federal website was a near-total failure, where most people find it impossible to apply. Some of the individual state exchanges failed as well, but others are successful. Kentucky’s and New York’s are most often cited as successes. In Kentucky, 39,207 people were found eligible for private insurance and 5,586 chose a plan. In New York, 134,897 were found eligible for private insurance and 16,404 chose a plan. So even in the most successful states, most of those who have been found eligible chose not to buy. Why?

In the absence of a poll to answer the question–one wonders why the government hasn’t produced any polls to answer this question–we can speculate. Perhaps some people were looking at their options but don’t plan to buy until later. Perhaps some people were so bowled over by the many wonderful options that they needed some time to recover before making their selection. But my guess is that the main reason is simple: people didn’t buy because the prices being offered were so high while the quality of the plans was so lousy.

I’m not really surprised. With all the bad publicity, I imagine a lot of people are thinking they’ll wait for the dust to settle. Plus, people are notorious for waiting until the last minute, and the enrollment runs through March. PLUS, it’s a brand new program, and it’s going to take time for people to get used to it.

I have my doubts about the ability of the legislators to predict how people are going to behave in this new environment they are creating, but I’m reserving judgement until at least mid next year. And then we’re going to have to look at the net-net. Some people are going to get screwed by the new law, and some people are going to benefit. As long as the latter considerably outnumber the former, then I think they can declare success. I, for one, never thought everyone was going to be better under Obamacare-- especially since I’m in the demographic most likely to be screwed by it.

We shall see.

Many of the people who are the intended recipients of the ACA’s inducements are by definition, poor. Hand-to-mouth people don’t have the money to pay insurance premiums for insurance that doesn’t kick in until January 1st at the earliest, especially with the holidays coming up. Such people will wait until the last moment to enroll, and to pay, for the insurance.

I can only speak for myself and my coworkers, so this is all anecdotal. But of the four of us, all of whom are eligible for the exchange and none of us having signed up so far.

  1. One person is upset that she will have to pay $175 a month, because ‘I thought it would be free’, so she plans to just pay the penalty and keep going to the emergency room when she gets sick.

  2. One person doesn’t have a computer at home and only has internet access at her daughter’s, and is trying to find somebody to explain the whole thing to her because she doesn’t really understand it, but she’s planning on signing up sometime this month.

  3. One person has COBRA, and while he wants to switch to a plan on the exchange because it’ll save him somewhere between $100-200 a month, is worried that, with all the problems, he’ll sign up, lose COBRA, and then it’ll get repealed and he’ll be without health insurance.

  4. I’ve signed up but haven’t picked a plan yet (even though I can see that will save me money), just because I figure I have another month or so, and want to take the time to review the plans.

So, now its totally a failure. Because of you. Nice going, Captain.

The thing is, while, from a program standpoint, it’s bad if everybody waits till the last minute and I’m sure the White House doesn’t want that because it can overload an already crappy and buggy system, whether I get the insurance tomorrow or December 16th, it won’t take effect until January 1st, anyway, so why hurry in that regard? This seems a little bit like saying that this whole “income tax” thing is a failure, because here it is February 15th already and they haven’t gotten many completed returns yet.

If a new big government program comes along, most of any voluntary participation will be from those who perceive a net personal benefit. It won’t be voluntarily participated in by those who see a net personal immediate cost.

If those supporting Obamacare thought very many people other than “the poor” would be happy buying insurance, they were badly mistaken.

Our insanely expensive medical system has insanely expensive insurance because medical care is essentially free to the destitute (among other reasons). In our system, those who actually pay for their medical care are also picking up the tab for those who do not pay anything. I find the idea risible that the masses would flock to buy insurance.
Free medical care?..Where do I sign up?
Medical insurance?..Who will pay for my policy?

But insurance fundamentally only works if the masses do not come out ahead. We must have a lot more paying in to the pool to pay for the few who are sick and take out more than they pay. Doesn’t work otherwise. So de facto we will have a lot more people coming up short and a much smaller number coming out ahead.

The warm and fuzzy feeling I get knowing that my fellow man is not suffering without medical care may be a substantial non-economic benefit to the masses. But it does little to change the fact that more people are paying more for insurance so that relatively few will come out ahead.

Igee: Perhaps I should have been clearer but I meant to compare where we ae now to where we will be post-Obamacare. We have an insurance system now, so it already has that “problem” associated with it. The question is whether the “problem” gets better or worse overall.

I’m sure that this will be factor for some people. However, I’d expect the effect will be limited, because people below the poverty line (and those below 133% of the poverty line in some states) aren’t shopping on the exchanges. Of course there are a few people above the poverty line that we’d still consider poor, but for the most part the exchanges are for the middle class.

Anyone who wants his or her new insurance to start Jan. 1 has to enroll by Dec. 15. I agree that many folks wait for the last minute. Still I’d like to think there are a fair number of people who want to get their insurance nailed down as soon as possible. My wife and I certainly do.

The bottom line is this: no company would be happy to launch a new product and see sales be only a tiny fraction of the most pessimistic projections for the first six weeks. If I ran an insurance company, or I was a politician who’d glued my fate to this law, I’d be getting a bit nervous.

I’m not sure about the numbers being thrown around. A week or so ago, it was announced (in the Denver Post) that 250,000 policies had been cancelled. Today there was an article stating that in the vast majority of these (2/3rds, the policy holder was given an opportunity to renew the policy for 1 more year (like the law required).

The Post speculated that the original numberr given out by the Department of Insurance was for political purposes. Here is a link to the article.

Whether this indicates that we are getting bad numbers from all states should become apparent in future weeks.


The poverty line is $11,170 for a single person, and $23,050 for a family of four. 133% of the poverty line is $14,856 for a single person and $30,656.50 for a family of four.

I wouldn’t call somebody making $15,000 middle class, and I certainly wouldn’t call somebody making $11,200 middle class.

Not understanding. How can $11,170 be poverty for a single person, but barely twice that for a family for four?

Kids don’t eat much.

Plus you can eat the children if need be.

Not much to understand - lots of costs don’t scale directly when you add people…

Eg: the costs sure include accommodation - but two people can stay in the same size room as one person, and heating that room doesn’t change with the extra person.

Also, the relevant “poverty line” here is the Medicaid line, which is different state-to-state. In Alabama, if you make like $5 and your employer smiles at you then you are above the poverty line. In Minnesota, a family of four can get Medicaid and be firmly middle class.

Unsurprisingly, the states that refused to set up their own exchanges are also the states with the most uninsured people and are also the states with the lowest poverty lines.

Are you sure about that? All the sources I looked at only referred to the federal poverty line that CA posted.

I’m unclear on which premise you’re questioning: that the poverty line varies, or that eligibility for ACA subsidies is based on the state medicaid line?