How Many Will Obamacare Cover?

Enrollment Numbers

Amy Goldstein passes along the latest enrollment predictions for next year:

Health and Human Services Secretary Sylvia Mathews Burwell announced that, by the end of 2015, 9 million to 9.9 million Americans probably will be in health plans sold through the federal and state insurance exchanges created under the health-care law. The administration’s expectations are as much as roughly 30 percent beneath the most recent prediction of the Congressional Budget Office that 13 million people will have health coverage through these exchanges next year.

Weissmann judges that the “the announcement is probably a wise move politically”:

Whether the issue was the effect of stimulus spending or the pace of Affordable Care Act sign-ups, the Obama administration has never exactly benefited from setting high expectations. During last year’s open-enrollment period, it had to deal with the endless media speculation over whether it would hit the CBO’s projection of 7 million sign-ups. It’s better to keep the bar low and clear it than trip over a nice-sounding but maybe overly ambitious target.

Suderman agrees that the administration may be “lowering the bar so that an underperformance looks like a relative success.” But, to him, it also “suggests that the administration is anxious about enrollment trends for year two”:

The second year of enrollment was always going to be somewhat more difficult, because the people most motivated to purchase plans through Obamacare’s exchanges were likely to have bought in year one. The task of year two would be to motivate even more people, those who weren’t already interested in purchasing coverage through the exchanges.

What this announcement indicates, then, is that the administration thinks it’s going to have a hard time motivating many people to purchase plans, which is another way of saying fewer people than expected seem to want or believe they need insurance under the law. For whatever reason or reasons, the demand isn’t there, and Obamacare is now expected to underperform as a result.

Jason Millman identifies a more mundane reason for the lower prediction:

One of reasons the projection is shifting downward comes from uncertainty over the number of people expected to leave employer coverage or individual health plans purchased outside the marketplaces, or exchanges. The CBO, for example, projects 7 million fewer people will have employer-based health insurance by 2016, creating a new pool of people potentially eligible for marketplace coverage. The administration says it’s still not clear how dramatic the shift in employer coverage will be.

Joseph Antos lists other possible explanations. Among them:

The administration’s 7.1 million figure is the number of people who chose a plan on the exchanges. Although many of those people paid their premiums and remain enrolled, others may have paid for a month or two before deciding that the value of Obamacare coverage is not worth the cost. We will never know how many people selecting exchange plans actually followed through for the full year.