Obamacare Enrollment Is Back on Track

US President Barack Obama waves and smiles after a reporter asked a question during his departure from the White House in Washington, DC, September 20, 2013.
National Journal
Sam Baker
Add to Briefcase
Sam Baker
Feb. 12, 2014, 10:18 a.m.

With two months left to go, Obama­care en­roll­ment is on track to hand the White House a sig­ni­fic­ant win over the law’s crit­ics.

About 3.3 mil­lion people had signed up for private in­sur­ance plans through the end of Janu­ary, ac­cord­ing to new data the Health and Hu­man Ser­vices De­part­ment re­leased Wed­nes­day. Janu­ary it­self was a little bet­ter than ex­pec­ted, and the growth put the ad­min­is­tra­tion with­in reach of a strong total when open en­roll­ment ends in March.

There are sig­ni­fic­ant gaps in the data that could af­fect as­sess­ment of the law’s ul­ti­mate suc­cess, but bar­ring any wild sur­prises, things are look­ing good for the White House.

Here’s what you need to know from the latest data:

En­roll­ment is on track

The en­roll­ment pro­cess has re­covered from the dis­astrous Health­Care.gov launch, and has made up a lot of the ground it lost to the web­site’s dys­func­tion.

Tak­ing Health­Care.gov‘s woes in­to ac­count, the Con­gres­sion­al Budget Of­fice now ex­pects about 6 mil­lion people to sign up by the end of the en­roll­ment win­dow. We’re two-thirds of the way in­to open en­roll­ment, and the law is 55 per­cent of the way to that tar­get.

Some of the law’s crit­ics will surely want to judge en­roll­ment against the tar­gets CBO set be­fore the Health­Care.gov launch, which puts it fur­ther be­hind — but still not by much. Real-life en­roll­ment is 25 per­cent short of HHS’ pre-Health­Care.gov es­tim­ates.

Janu­ary saw a slight drop-off, as ex­pec­ted

White House of­fi­cials and health policy ex­perts fully ex­pec­ted Janu­ary en­roll­ment to be lower than Decem­ber’s. They figured Decem­ber would rep­res­ent an en­roll­ment surge, as people tried to meet the dead­line to get cov­er­age that began on Jan. 1 — the earli­est pos­sible date — and ex­pec­ted en­roll­ment to taper off in Janu­ary and Feb­ru­ary.

The drop-off happened, but it was small. About 1.8 mil­lion people en­rolled in Decem­ber, com­pared with 1.1 mil­lion last month.

The num­ber of young people is steady

Any­one who wants Obama­care to work wants to see a lot of young people sign up. (Really, they want to see a lot of healthy people sign up, but we use age as a proxy for health status.)

The ra­tio of young adults was largely un­changed in Janu­ary, hold­ing at about 25 per­cent. That num­ber needs to go up, but it’s still too early to pan­ic. Young people were al­ways ex­pec­ted to sign up at the last minute.

Ini­tially, the White House said it wanted young adults to make up about 38 per­cent of all en­rollees. Sit­ting at 25 per­cent now is a sign that the bench­mark — or something close to it — is achiev­able by the end of March. The mix is good enough now to avoid a “death spir­al,” ac­cord­ing to the Kais­er Fam­ily Found­a­tion, but the high­er the per­cent­age of young en­rollees gets, the lower the like­li­hood of big premi­um in­creases next year.

We don’t know how many people are truly en­rolled

As usu­al, HHS’s re­port con­siders people “en­rolled” as long as they’ve gone through the pro­cess and se­lec­ted a plan. But you’re not truly en­rolled — you don’t have in­sur­ance that you can use — un­til after you’ve paid your first month’s premi­um.

It’s safe to as­sume that some num­ber of people haven’t made that pay­ment, but we don’t know how many. Un­til we do, we won’t know how many people truly are en­rolled in health in­sur­ance via Obama­care.

We don’t know how many un­in­sured people are get­ting covered

The goal of the Af­ford­able Care Act wasn’t simply to cov­er mil­lions of people, but to re­duce the num­ber of un­in­sured by mil­lions of people — 6 mil­lion in the first year, ramp­ing up to about 24 mil­lion, ac­cord­ing to CBO’s es­tim­ates. But ini­tial re­ports sug­gest that a lot of the people get­ting covered through the ex­changes were already in­sured; they’re chan­ging their cov­er­age rather than gain­ing it. For now, no one really knows how many pre­vi­ously un­in­sured people are in­cluded in the 3.3 mil­lion total, but that will be a key met­ric of Obama­care’s suc­cess.

What We're Following See More »
Johnson on Ballot Everywhere, Followed by Stein, McMullin
1 hours ago
Is McMullin Building the GOP in Exile?
2 hours ago

Evan McMullin, the independent conservative candidate who may win his home state of Utah, is quietly planning to turn his candidacy into a broader movement for principled conservatism. He tells BuzzFeed he's "skeptical" that the Republican party can reform itself "within a generation" and that the party's internal "disease" can't be cured via "the existing infrastructure.” The ex-CIA employee and Capitol Hill staffer says, “I have seen and worked with a lot of very courageous people in my time [but] I have seen a remarkable display of cowardice over the last couple of months in our leaders.” McMullin's team has assembled organizations in the 11 states where he's on the ballot, and adviser Rick Wilson says "there’s actually a very vibrant market for our message in the urban northeast and in parts of the south."

Clinton Up 9 in USA Today Poll; Up 3 According to Fox
3 hours ago

A new USA Today/Suffolk University poll finds Clinton leads Trump by 9 points nationwide, 47% to 38%. A Fox News national poll has Clinton up just three points, 44% to 41% over Trump.

Too Many Potential Enrollees Paying Obamacare Penalties Instead
4 hours ago

One of the main reasons for the recent Obamacare premium hikes is that many potential enrollees have simply decided to pay the tax penalty for remaining uninsured, rather than pay for insurance. More than 8 million people paid the penalty in 2014, and preliminary numbers for 2015 suggest that the number approaches 6 million. "For the young and healthy who are badly needed to make the exchanges work, it is sometimes cheaper to pay the Internal Revenue Service than an insurance company charging large premiums, with huge deductibles."

Cruz: Eight Justices Could Be an Ongoing Situation
5 hours ago

Sen. Ted Cruz (R-TX) said that "there was “precedent” for a Supreme Court with fewer than nine justices—appearing to suggest that the blockade on nominee Merrick Garland could last past the election." Speaking to reporters in Colorado, Cruz said: "I would note, just recently, that Justice Breyer observed that the vacancy is not impacting the ability of the court to do its job. That’s a debate that we are going to have.”


Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.