Obamacare’s Monthly Check-Up

The latest ACA numbers, in a nutshell:

About 4.2 million people have signed up for health plans on Obamacare exchanges through the end of February, making it unlikely that the Obama administration will hit the estimate of 6 million enrollees by a key deadline at the end of March. Whatever momentum appeared to be building in January dropped off in February, as the number of sign ups fell below the administration’s expectations.

Which is a big reason why Obama took to the ferns. Philip Klein thinks it’s “worrisome for backers of the law is that young people still aren’t signing up in the numbers the administration once deemed necessary for the program’s viability”:

The White House had originally said nearly 40 percent of the 7 million Americans initially projected to enroll would have to be young and healthy to offset the cost of covering older and sicker Americans. When initial signs pointed to low youth enrollment, many supporters of the law argued that younger individuals would enroll later in the process.

But in February, individuals between 18 and 34 years old made up just 27 percent of those signing up — the same as January. Cumulatively, just 25 percent of signups have come from that age demographic.

McArdle is on the same page:

Unless we get a huge rush of young people signing up at the last moment — which is entirely possible — the insurance pool is going to be much older than expected, and that probably means it will be much more expensive than projected. In that event, either the federal government will have to make big payments to insurers through its risk-adjustment programs, or the price of policies will probably rise significantly next year.

More cold water from Suderman:

The administration is still counting sign-ups, not completed enrollments—so the real number of paid enrollments is substantially lower. The monthly “enrollment” reports released by the administration don’t actually count enrollments. Instead, they count people who have “picked a plan” within the exchange system. But multiple reports from insurers suggest that about 20 percent of people who sign up aren’t paying their first month’s premium, and thus aren’t enrolled. Other reports suggest a further attrition through non-payment of around 2 to 5 percent in the second month. What this means is that whatever the final number of sign ups is, the true number of enrollments will be significantly smaller.

Christopher Flavelle argues that the “worst-case scenario for Obamacare enrollment isn’t that premiums go up because the risk pool was worse than expected”:

Rather, it’s that Democrats overestimated the demand among Americans, and particularly young Americans, for insurance coverage that’s both less generous than employer-based plans and more expensive than the plans prohibited by the law.

There’s no reason yet to think that’s happening. It’s possible that the number of young people who’ve signed up for so far — a little over 1 million — will double, or more, by the end of open enrollment. If not, it’s possible the tax penalty will persuade more of them to sign up next year.

But after five months of open enrollment, the level of demand among young Americans to buy subsidized health insurance remains unclear. The answer to that question matters a lot more than what happened last month.

Finally, via Cohn, here’s a reaction from Kaiser VP Larry Levitt:

This enrollment report is somewhat ho hum, which in some sense is good news for those running the program. It means that things are basically on track. Most of the uninsured were never expected to sign up in year one, and because of the early technical problems, actually enrollment will probably fall short of expectations.  At this point, though, the program is pretty much functioning as anticipated.

In terms of what this all means for the number of Americans uninsured or how people feel about the coverage their getting, we’re unfortunately going to have to be patient until reliable numbers are available.