Obamacare stats: Apparently we need a new definition of ‘train wreck’


Positive news reports about insurance enrollments under Affordable Care Act have been coming out so steadily that they barely make headlines anymore. Still searching for a way to depict Obamacare as a “train wreck,” GOP critics of the law have no option but to make up the bad news.

Before we get to that, let’s examine the latest statistics from the Department of Health and Human Services, released Thursday. The HHS report, which updates figures to April 19, toward the end of the extended enrollment period for 2014, reveals that a total of 8.02 million people enrolled in individual health plans through the federal and state ACA marketplaces since Oct. 1. On the face of it, this beats the expectations of 7 million enrollments for the first year of the ACA.

Some of the enrollment trends tracked very closely to what experts anticipated, based on the experience of the Massachusetts healthcare reform (“Romneycare”). One expected trend was that enrollment would surge as the March 31 deadline approached; sure enough, 47% of enrollments came in the final month.


Another was that the share of younger people in the mix would increase sharply toward the end, healthy “young invincibles” being especially likely to procrastinate. Sure enough, the proportion of people aged 18 to 34 increased from 24% during the period between Oct. 1 and Dec. 28, 2013, to 31% during March.

Overall, 28% of private plan enrollees are in this age group, which is close enough to their ratio in the general population (about 40%) to eradicate fears of a risk-based insurance “death spiral.” As we reported months ago, the ACA incorporated several provisions to cover disproportionate enrollments by older and sicker customers anyway, but these figures suggest that in general those provisions won’t be needed.

The HHS report doesn’t help much to answer the question of how many enrollees were previously uninsured, which is one of the obsessions of Obamacare critics on the right. It does offer a curiously positive statistic, though one which HHS officials are treating verrrry cautiously: Of the 5.2 million people who applied for ACA subsidies via the federal enrollment website and therefore were asked about their current insurance status, only 13% said they “had coverage at the time of application.”

Simple math would suggest that this means that close to 87% of enrollees were previously uninsured, but that’s an extreme interpretation, and the HHS isn’t banking on it. The problem is that the individual insurance market is extremely volatile, so the statistic doesn’t reveal if these people had been uninsured for one month, 12 months or forever; or if they had simply dropped their coverage in anticipation of signing up for 2014; or if they misunderstood the question.

Other surveys, HHS officials acknowledged during a press briefing Thursday, show the absolute decline in the uninsured to be somewhere in the range of 5 million to 10 million -- from all aspects of the ACA, including expanded Medicaid.

Then there’s the question of how many enrollees have paid their initial premiums, which makes their enrollments official. Here’s where the GOP has moved into the realm of fiction. Republicans on the House Energy & Commerce Committee released a survey Wednesday claiming that only 67% of enrollees in the federal marketplace have paid.

Compared with other surveys on the topic, this looks like an exceptionally low number. Most other surveys have placed the figure at an average 85%, with some as high as 95%. (California’s state exchange, Covered California, says insurance firms are reporting 85% payment.)

Obamacare enrollment tracker Charles Gaba calls the House report “embarrassingly flawed” and, with uncharacteristic bluntness, a “pile of crap.” He points out that the report assumed erroneously that premiums on all enrollments were due no later than April 15, whereas only 63% of all enrollment payments were due by then, with the rest due Wednesday (April 30) or even sometime in May. That’s a big enough mistake to invalidate the entire study. Gaba adds further that figures from state exchanges in Washington, Massachusetts, Oregon, Minnesota and Connecticut are all coming in at 95% paid or above; there’s no reason why enrollments on the federal exchange should vary significantly from those figures.

Here’s the takeaway: The GOP’s campaign against the Affordable Care Act is still at full cry, but it’s becoming more desperate with every passing day.