Public Exchanges

Viewpoint: Everyone Can Celebrate New Obamacare Numbers

by: Christopher Flavelle
January 14, 2014

(Bloomberg View) Today the federal government released the most comprehensive data yet about who signed up for Obamacare through Dec. 28. There's reason to cheer for both the law's supporters and its detractors. Let's start with the good news for Obamacare fans. President Barack Obama's administration predicted -- or, well, prayed -- that enrollment in the law's state insurance exchanges, which was initially anemic, would accelerate toward the end of 2013, as the deadline approached for getting coverage by this month.

As you can see from the accompanying charts, that prediction came true: More than 2 million people had chosen exchange plans by Dec. 28, almost a five-fold increase over the number enrolled a month earlier. The number of people who were deemed eligible for Medicaid also increased, but not at the same rate as private coverage.

The accompanying chart also shows that federally run exchanges, which initially performed worse than those operated by the states, are now enrolling people at a quicker rate than state exchanges. That's a validation of sorts for the Department of Health and Human Services, as it supports the notion that it's learning from its early mistakes.

There's still plenty of work to do. For starters, in some states the number of women enrolling in Obamacare coverage exceeds the number of men, out of all proportion with demographics. But that doesn't mean the law isn't working; it means the administration needs to find better ways to persuade men to sign up for coverage.

Now, the good news for detractors. The government said last year that to get the right balance between healthy and sick people on the exchanges -- and, by extension, to produce affordable premiums -- it needed 2.7 million people between 18 and 34 to sign up for coverage. That's about 40 percent of the estimated seven million who would sign up overall for 2014. The accompanying chart shows the exchanges aren't hitting that goal. Just 24 percent of those who have chosen a plan were between 18 and 34. By contrast, the largest share of enrollees -- one third -- are between 55 and 64.

(There's a caveat here: The administration could claim that its definition of young and healthy covered everyone under 35, including the 6 percent of exchange enrollees who are under 18. That would still leave it short of its stated goal, as well as looking a touch eager to persuade the naysayers.)

As you can see from the right-hand side of the chart, that's significantly different from the age breakdown of the uninsured population, which skews much more heavily toward the young. So one of two things is happening here. Either the old and sick are self-selecting into Obamacare, which spells trouble for insurers (and, by extension, the government, which backstops insurers against higher-than-expected risks). Or young people without insurance are taking their sweet time signing up but will do so before the March 31 deadline. The administration is obviously hoping for the latter.

Today's numbers don't settle the question of whether the administration will hit its goals for enrollment in the exchanges, measured either in raw numbers or demographic breakdown. But they show that those goals are within reach.

Flavelle is a member of Bloomberg View's editorial board. Follow him on Twitter.

Comments (2)

Posted by: Frances R | January 14, 2014 1:56 PM

Nothing Obamacare does will change the fact it is a statist program that will not work no matter how much the administration tries to bankrupt the country. Insurance companies and the AMA agreed to this monstrosity in exchange for political gain and (no surprise)the Democrats did not really deliver on their promises. The young are not stupid so I would not expect them to sign up for expensive insurance that covers things they don't want. Only a market economy can produce real choice based on consumer preference-Obamacare is being forced down your throat and guess what?-pretty much nobody wants it...not even Obama or Congress want to participate in the program they foist on you.

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Posted by: John S | January 14, 2014 10:42 AM

And what if only the Young NOT healthy sign up? All of the hype is about the young, while forgetting many young are not healthy. If this becomes another program that only covers NOT well - it's sunk.

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