The Uninsured Aren’t Signing Up?

Last week the WSJ reported that “the majority of the 2.2 million people who sought to enroll in private insurance through new marketplaces through Dec. 28 were previously covered elsewhere.” Laszewski responds:

If this continues, people will be asking a very big question come election day:

While we needed to do health insurance reform, why did we have to do it in a way that so disrupted the existing individual and small group market if the people it was supposed to benefit, the uninsured, weren’t going to buying it?

McArdle thinks these numbers could indicate two things:

First, would-be applicants may simply be waiting until March. They’ve gone without insurance a long time; why not wait a few more months and save on premiums? The second possibility is more troubling:

There may be something seriously wrong with our understanding of who the uninsured are, and what they are willing and able to buy in the way of insurance. I don’t know exactly what the fault may be in our understanding. But if the numbers stay this low, I’d say we need to reassess the state of our knowledge about the uninsured — and the vast program we created to cover them.

Sprung looks on the bright side:

1) It is perhaps not that surprising that those accustomed to shopping for insurance would be quicker to buy on the exchanges.

2) According to HHS, 79% of those enrolled in exchange plans so far qualified for subsidies. It does seem surprising that a high percentage of those buyers were already able to afford insurance on the individual market. Perhaps current signups, at least those coming from the indvidual market, lean toward the higher end of the subsidy scale, say 200-400% of the Federal Poverty Level.

3)  Weaver and Mathews emphasize insurers’ worries that they’re not getting new customers so much as churned existing ones. On the other hand, the already-insured are likelier to be healthier than the uninsured,  perhaps easing worries that the early risk pool will skew too sick.

He later questions the validity of the research the WSJ relies on. Suderman’s view:

Given the fuzziness of the data, it’s still hard to tell exactly what’s happening. And even if it’s true that there are no more uninsured now than there were last year, there’s still time for that to change. As the administration is keen to remind us, people who want coverage have until the end of March to sign up for coverage this year. But even still, this doesn’t exactly bode well for Obamacare’s future. Certainly, the law isn’t off to the kind of start that the administration hoped for, or promised.

Tyler Cowen’s two cents:

I would emphasize that we still don’t really know quite what is going on here.  But the view that everything is now in the clear simply is not warranted by the available evidence.