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Cross-posted at
An interesting, but hardly surprising development today: The CBO, which had previously projected that appx. 7 million people would enroll in Private QHPs via the Health Exchanges created by the Affordable Care Act (as well as 9 million additional people enrolling in Medicaid or CHIP thanks to the expansion provisions within the ACA) by the end of 2014 have now reduced both of these projections by 1 million apiece, to 6 million and 8 million in the first year. Thanks to Dan Diamond for bringing this report to my attention.

You have to scroll all the way down to page 108 of the report to find it, but here's the relevant screen shot, and the relevant paragraph from pages 112 - 114 of the report:

Lower Enrollment in the Exchanges, Medicaid, and CHIP

In light of technical problems that impeded many people’s enrollment in exchanges in the first months of the open enrollment period, CBO and JCT have reduced their estimate of enrollment for the current year from 7 million to 6 million people. Between October and late December 2013, about 2 million people selected a health insurance plan through an exchange.11 That figure is significantly below the total that CBO and JCT estimate will enroll in 2014. However, the open enrollment period lasts through March, and CBO and JCT anticipate that, similar to initial enrollment patterns for other new health care programs, the number of people who sign up will increase sharply toward the end of the period. In particular, people who choose to enroll primarily to avoid a penalty for being uninsured may wait until the end of the open enrollment period to choose a plan. Thus, it is possible that the number of enrollees will reach the 7 million originally projected for 2014, just as it is possible that the number will fall short of the current estimate of 6 million. In any event, CBO and JCT estimate that enrollment in exchanges will rise sharply in the next few years—reaching 22 million by 2016—as people become more familiar with the new insurance options and subsidies.

In other words, the mess with the website (as well as some of the state-run exchanges, some of which, such as Oregon, Hawaii and Massachusetts are still having serious problems) back in October and early November effectively killed the first 20% of the 6-month enrollment period, so they're knocking their projections down a peg or two. Interestingly, even though they're dropping 2 million off of these figures, they only project the reduction in uninsured to go down by 1 million, which I assume is due to a mish-mash of rounding numbers, demographic changes and the like.

So, how does this impact The Graph or The Spreadsheet on this website?

Frankly, I'm inclined not to really change anything, other than to include a prominent note about this change. Politically, no one is going to care that the CBO dropped their projections, especially when they did so over 2/3 of the way through the enrollment period. The bottom line is, if Private QHP enrollments reach between 6-7 million, it'll be spun as an unqualified success. If it hits between 5-6 million, it'll be considered a "qualified" success (ie, "considering the technical problems in October" will be included with every reference). If it comes in below 5 million by March 31st, it'll be spun as a disappointment or a disaster...which, of course, ACA opponents will call it no matter what.

Of course, as the CBO report notes, it's also possible that they'll hit 7M after all. More importantly, what really matters won't be whether 5, 6 or 7 million enroll this year, but how it plays out over the next several the CBO also notes. Personally, I had already noted (on Twitter a few days ago) that I expect them to hit somewhere around 6 - 6.5 million, which isn't particularly profound either.

In the words of Jeb Bartlett...what's next?

Oh, one other interesting tidbit: You know how the freakout over the "OMG! 5MM Policies Cancelled!!" led President Obama to allow a 1-year extension (at the individual states' discretion) of non-ACA-compliant policies? Apparently the CBO has some numbers on that as well:

Random note: CBO expects about 1.5 million people to renew non-Obamacare-compliant policies under WH's administrative fix.
— Dylan Scott (@dylanlscott) February 4, 2014
Meanwhile, two new updates out of Colorado and Washington State:

Colorado: Private up slightly, Medicaid/CHIP up 15.6% since 1/15

Washington State: Private QHP up 7,700 in last week of January; Medicaid up over 19,000

Finally, here's the latest tally including the above:

Private QHPs (exchange): 3.02M
Private QHPs (other): 300K

Medicaid/CHIP: 7.5M
Sub26ers: 3.1M

Grand Total: 13.92M

Enrollment Period Elapsed: 69.2%

Original CBO Private QHPs (exchange) Projection Attained: 44.5%

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Comment Preferences

  •  Thanks for all your work on this. n/t (5+ / 0-)

    Fry, don't be a hero! It's not covered by our health plan!

    by elfling on Tue Feb 04, 2014 at 09:52:59 PM PST

  •  ACA estimates (0+ / 0-)

    Wasn't the 7 million (now 6 million) projection for sign-ups via the exchanges to be as of March 31, 2014, rather than "the end of 2014"?

  •  LOL (1+ / 0-)
    Recommended by:

    ACA Death Spiral

    Exploring the likely implosion of the Affordable Care Act
    No, 10 million have not gained coverage through the ACA
    Tag Archives: Gaba spreadsheet
    He claims that the numbers are all wrong, but
    There are, actually, two things I like about the Marshall/Klein blog entries. The first is that Marshall points readers to the ”Gaba spreadsheet.” This is one of several attempts to actually track enrollments under the Affordable Care Act.  It is a useful resource that, in conjunction with other data, should help people speak objectively about the ACA.

    Ceterem censeo, gerrymandra delenda est

    by Mokurai on Tue Feb 04, 2014 at 10:29:08 PM PST

  •  The surprise that I hope economists notice (0+ / 0-)

    is that way more people seem to be in the Medicaid-expansion slice than the CBO estimated. That doesn't surprise me -- we knew an awful lot of people have been struggling in near-poverty (actual poverty, if the poverty measurement were not stuck back in the 1960s).

    From Brainwrap's figures, it looks like the ratio of private:Medicaid is running about 1:2, even with so many states rejecting the expansion. But the CBO is still projecting 3:4. Unless the economy improves dramatically, and/or the minimum wage and unemployment rates get revised (not going to happen), that's quite unlikely.

    Cue up the chorus of "Oh no! Medicaid expansion under Obamacare will destroy the Federal budget and end civilization as we know it!"

  •  Any number below 7M will be blasted by GOP (0+ / 0-)

    In fact, they're still talking about 4M losing their health insurance so they will likely claim that 7M is really only 3M.  

    •  And they would be correct...EXCEPT... (0+ / 0-)

      ...that they also aren't including the "off-exchange" enrollments  (direct via ins. companies), the SHOP enrollments (tiny though those may be) and some percentage of the new Medicaid enrollments (some people who didn't qualify for Medicaid prior to expansion were paying through the nose for private insurance and no longer have to now).

  •  Private Enrollment Reduced by Obama Rule Changes (1+ / 0-)
    Recommended by:

    Remember that when Obama changed the rules permitting more people to keep their non-compliant private policies, he also reduced how many people would be transferring their insurance from the private market to the healthcare exchanges.  This 1.5 million now keeping their non-compliant policies would originally have totally dropped their insurance policies or more likely have transferred their new policies to the new exchanges.  

    If we assume that around two thirds of the 1.5 million now keeping their non-compliant policies would have transferred into the exchanges because they could have obtained a really good deal using subsidies on the exchanges, then we would expect one million fewer people on the exchanges now versus the original CBO estimates because of these people keeping their non-compliant policies.  

    Consequently, any decrease that we may see on the exchanges is at least in part, or its entirety, being caused by the smaller number of people transferring out of the private market to the exchanges caused by the changes to the rules allowing them to stay in the private market.

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