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Obamacare's October Numbers Are Going to Be Low

The real detail to watch is still to come

AFP: Tim Sloan

The Department of Health and Human Services will release initial enrollment statistics for Obamacare sometime this week, perhaps as early as Tuesday. But the disputes have started already. Christopher Weaver and Louise Radnofsky of the Wall Street Journal are reporting that no more than 50,000 people successful enrolled in insurance plans via last month. HHS officials refuse to confirm the figure and there's a whole separate dispute over the definition of "enrolled." (Does it count if somebody has chosen a plan but not paid the first premiums? The administration says yes and its critics say no. Sarah Kliff of the Washington Post has that story.)

I have no idea if the Journal's number is right. (Their reporting has been very good, so I'm not about to bet against them.) But nobody I know expects the October enrollment figures to be high. One reason is that very few people buy insurance at the beginning of open enrollment periods. This is true for public programs and this is true for government initiatives. By now, you may have seen the figures from Massachusetts. Just in case, here they are again, with the explanation I gave a few weeks ago:

Of the 36,167 people who eventually enrolled in premium-charging plans from Commonwealth Care, 123 signed up in the first month. That’s right—one hundred and twenty-three, or about 0.3 percent. Over the first two months, the number was a bit larger—2,289. But that’s still just 6.3 percent. 

The analogy to Obamacare is far from perfect, in that Commonwealth Care didn’t include wealthier people who didn't qualify for subsidies. (In the Massachusetts scheme, they essentially had a separate exchange—and enrollment there began half a year later.) Also, the Massachusetts open enrollment period was twice as long. So it’s reasonable to expect that, with a fully functional website, early enrollment in Obamacare private plans would be higher than those numbers above suggest. But the general point stands. Very few people sign up for insurance in the first few months. Most wait until much later in the game. 

But that’s not the whole story. barely worked at the start and still isn't working that well now. We know already that, on October 1, only six people enrolled in plans via Statistics for the rest of October probably don’t look great, either. States running their own marketplaces seem to be doing better, although, according to an unofficial tabulation from Avalere Health, those numbers are uneven and vary a lot from state to state.

In short, the October numbers were always going to be low. But, thanks to technology problems, they'll probably be even lower, although by how much is impossible to say.

Still, the Medicaid numbers will be a lot higher. That should count for something. As for private insurance, what was true before October is true now: The statistics that really matter are the ones in December and beyond. "Enrollment in new programs begins slowly and often takes several months to build momentum," Dan Mendelson, CEO of Avalere Health, said in a statement accompanying the release. "While initial enrollment has been lagging, with aggressive marketing there is still time for awareness of the program to grow and participation to begin." 

So there's still time—just as long as and the poorly functioning states are operating better by late November. And if they're not? Then the problems get a lot more serious.