According to a Bloomberg article this morning, 100,000 people purchased insurance on the federal exchanges in November alone. That’s nearly 4x more than the nearly 27,000 who bought insurance on the federal exchanges in October.
127,000 enrollments nationwide may sound low, but it’s actually very promising for a number of reasons. First off, if you look at when people actually bought health insurance in Massachusetts when they rolled out their own Obamacare, you’ll realize that the lion’s share of enrollments will happen just before the deadline to buy. There’s no empirical reason to believe that the same thing won’t happen nationally.
Secondly, those 127,000 people represent enrollment in just the states who have governors that refused to help their constituents get affordable insurance. That number does not include people in NY, CA, KY, or the other twenty-three states who took the medicaid expansion and set up their own exchanges. California alone has enrolled 80,000 people, and Kentucky has enrolled about 50,000 people so that 127,000 federal enrollment number is already smaller than those of just two states who embraced the ACA. The number of people who have been able to purchase insurance as a result of the ACA is much higher than we’re currently aware of.
Thirdly, you need to look at the trend. A four time multiplier on the number of enrollments from one month to the next is much more telling than the overall number. This is especially true since we’re still four months away from the deadline to buy insurance.
But there is one factor that is more relevant to the success of the ACA than overall enrollment numbers; how many people under the age of 30 are signing up? We don’t yet know what that number is on the federal exchange. I don’t believe we’re going to know that number until March or April. But we do know what is happening in Kentucky. 41% of the people that bought insurance in Kentucky are under 31 years old. That’s a huge percentage that I never saw coming. I suspect (I don’t have the data on any other state yet) that the percentages will be similar in all of the states that elected to take the medicaid expansion, since Kentucky doesn’t have a substantively younger population than any of the other states. I also suspect that the national percentage of under 31s will be lower, absent the medicaid expansion. For the under 30 population in the expansion states, coverage is well under $100 a month. It will be around, or a little bit higher than $100 for those same people who live in states where their governors are trying to undermine Obamacare. It’s reasonable to expect that higher costs will equal lower enrollments. I would be shocked if that 41% were cut in half in the more expensive states. But if we assume that nationally, the under 30 percentage is 20%, we will definitely get the 2.9 million enrollments that we need to keep the current premium levels.
In other words, this reform is most assuredly going to work. None of the early indicators suggest otherwise to me. I must say that I’m pleasantly surprised at how well this is going. I was very skeptical was passed, but I’m always happy to be proven wrong by evidence.