Just a quick note concerning Obamacare enrollment. Compared to the comparable time point of the 2006 Massachusetts experience, Obamacare Exchange enrollment pace is matching Massachusetts’ enrollment pace for private insurance during the Bay State’s 2006 open enrollment period.
At 16% into the open enrollment period, 2,089 Massachusetts citizens had signed up. As a straight population adjustment (sum *48.75), that would translate into the national experience of roughly 102,000 people signing up. 106,000 people signed up via either the federal exchange or through state exchanges covering all but three Exchange jurisdictions according to the Washington Post. Three state run Exchanges have not reported their numbers so we can assume a slightly higher number.
Being slightly less charitable if we apply an adjustment to the raw population total to account for the fact that Massachusetts had a much smaller uninsured pool, (8.4% in 2006 vs. 15.4% US nationally in 2013), expectations would have seen 186,000 Obamacare enrollments.
However there is another adjustment that would reduce 186,000 expected pace downwards. The Massachusetts Medicaid expansion was only applicable to people up to 100% Federal Poverty Line. For the states that are taking Medicaid enrollment, people who make between 133% and 138% are eligible, so the total US national pool eligible for the Exchanges is smaller than the 1.83 factor adjustment implies.
Even with a crappy three weeks of website work, and pointed political opposition, the pace is either concurrent with the nearest relevant example, or slightly behind depending on how you want to model expected pace. That ain’t bad. (As a side note, I am curious as to why HHS was so optimistic about first month enrollment)
Additionally, Obamacare, even with the Supreme Court and the reactionary assholes neutering Medicaid expansion in half the country is signing people up for Medicaid expansion at a rate that surpasses Massachusetts’ experience in 2006.
Update 1: via a commenter in the Pittsburgh region, I was directed to this story concerning Pennsylvania enrollment.
Despite the glitches, Highmark’s health plans appeared to be an early favorite among people who were able to complete the shopping process. The company picked up 827 individuals through Nov. 2, or 37 percent of enrollees in the state.
That number doubled to 1,665 by Nov. 12, a trend Ash called “encouraging.”
Pennsylvania is a Federal Exchange state. Assuming Highmark is representative, the key is the November pace is at least 3x faster than the October pace, and that is without any time pressure to enroll yet for January 1st coverage.
jl
Thanks for putting the first month’s exchange enrollment numbers in context.
As I was reading this I heard a radio news report that Covered California enrolled almost 30,000 in October, and if I understood the report correctly, will be probably a little over another 30,000 in the first 2 weeks of November. The enrollment numbers were a little over expectations.
I’m not sure whether these numbers include Medicaid enrollment, and not sure when numbers I hear in the news include those or not. Would be nice to get that straight as soon as the information is available.
Edit: the director of the state exchange said he expects a crush of enrollments as deadline approaches and people make up their minds and ready to pay. California has a look around and window shop first, then register and enroll approach.
Tommy
I wonder what these numbers mean. I work for myself. I was on Healthcare.gov like the second it opened. I spent the better part of a week getting logged in and getting quotes (including doing it at like 3 AM). What I found I was staggering. I will save a lot of money ($87/month) for a better plan (no incentives). I have NOT enrolled. I just created an account, got verified, and then downloaded the info on 10-12 plans to review.
I don’t know if others are doing as I did, and I won’t wait to the last second, but I didn’t need to enroll this very second. Last month. This month. Heck next month. I was, dare I say shopping! Checking prices.
But I will. Just thinking out loud but wonder if many more folks are doing just what I did?
Paula
I’m saving close to $100 a month on insurance if I have my information right. I am going through Covered California and no, I haven’t even signed up — just shopping prices.
Fuck anyone who tries to mess this up for me, from the Republicans to fucking trolls who don’t understand how insurance works.
Violet
Yeah, me too. If you’re just going on Medicaid, then there aren’t decisions to be made. Otherwise, people need time to sort through the plans.
Tommy
@Paula: Didto as I said above. Just as you said, “shopping prices.” And also “Fuck anyone who tries to mess this up for me.”
I had one of those terrible insurance plans that is getting shit canned. I always had amazing care. Lost my job. Took that “cheap” plan. I almost died. Freak thing. In the ICU with a tube down my throat for six days.
If not for my parents being rich I would have lost everything. Everything. My plan didn’t cover anything I thought they would cover. Left me with a bill of $57,000. Myh parents paid it. I never could have.
KG
Colbert has a piece on a small town in Colorado (I think)where a guy wants to allow drone hunting licenses. It is amazingly amazing. The guy thinks drooooooooonez can be used to enforce Obamacare… I’ve just come to the conclusion that I have no desire to ever live in a small town, ever. Seriously, what’s in the water in those square states in the middle?
KG
@Violet: because everyone approaches insurance like a kid with birthday money at the toy store… I mean, that’s Economics 101
Suffern ACE
@KG: For a second I thought you meant that the licenses were to be for hunting using drones. For the folks who want to go hunting, but don’t actually want to leave their heated homes.
Suffern ACE
@Violet: I would kind of like to see what they based those assumptions on. I know there is this notion that everyone without insurance is in some kind of crisis situation that needs to be addressed right away, but being without insurance for most people isn’t like being without running water.
KG
@Suffern ACE: I would totally hunt that way, but I’d need a Mars type rover to pick up whatever I killed, because I wouldn’t want off the couch
? Martin
@Tommy:
Having some experience with user opt-in systems with deadlines… We can pretty reliably predict our final number exactly 5/6 (10 days from the end of a 60 day process) of the way from the start of a process to it’s deadline. On that day, give or take a day, take the number of enrollees and double it. You do get a bit of surge at the beginning – the eager beavers, the people that didn’t face much of a decision because their options were limited, etc. maybe 5% of your final number if you’re lucky – and then you get nothing for a while, and then about halfway through it starts to ramp up – the eager beavers that needed a few weeks to decide and then the procrastinators that didn’t face much of a decision, and then it just ramps up right to the end. You see almost exactly the same trend for tax return filing, holiday shopping and pretty much every other social timeline, give or take the magnitude of the rampup at the deadline. We’re pretty predictable overall.
The problem is always that people don’t have all the information they need. They need time to gather it. They need time to figure out what information they need. They need even more time to figure out where the information they need might come from. And most people put things off. The almost a million people with applications in that haven’t chosen a plan is a rather encouraging number. You’re one of them. These folks are shopping, just as you are. Some of it is due to the problems with the rollout. I know a C-level at one of the new co-ops, and they started with big problems. He’s in several states – some are entirely healthcare.gov and some are shared state/fed exchanges. They didn’t get data at first – application data wasn’t coming through or was coming through wrong. Some of it was problems on his end, some on the healthcare.gov end, some on the state end. They’re getting it now, slowly, but he worked for big insurers before. He knows what signup rates are during open enrollment periods and isn’t worried about slow signup rates at this stage.
FreeAtLast
@KG:
The guy printed out drone hunting “licenses” and put them up for sale for $25. He actually sold 100 to townsfolk.
goblue72
Don’t look now, but ConservaDems Feinstein and Landrieu are currently plotting to ratf#ck the ACA.
Omnes Omnibus
@goblue72: You should read this.
mclaren
Richard Mayhew has mistaken efficiency for effectiveness. He points out correctly that the ACA is fulfilling its sign-up goals at a reasonable and sustainable rate, compatible with the long-term goals of getting the ACA’s numbers to work.
Mayhew utterly ignores the issue of whether getting the ACA to work will produce any significant improvement in the broken collapsing American health care system.
Efficiency is doing things right; effectiveness is doing the right thing. The ACA is doing things more or less right technically and economically and bureaucratically, but the ACA is not doing the right thing to reform America’s broken collapsing health care system. It’s a lot like congratulating ourselves on being on schedule in building a 747 with flapping wings. We may be on schedule and the design may be getting built correctly, but a 747 cannot fly by flapping its wings.
Violet
@Suffern ACE: And do any of the plans available on the exchanges begin before Jan 1, 2014? If the answer is no, why pay for the plan now, or last month? Why not wait, make sure you’ve got the one you want and pay in December? That’s how most people will do it.
jl
” being on schedule in building a 747 with flapping wings ”
It would be way cool watching one of those trying to get off the ground.
catclub
@goblue72: I’m not so sure. There provisions Mr Mayhew listed from the Landrieu proposal look like poison pills that the insurance companies will balk at. Thus GOP senators and the House will not even go along. No harm, no foul.
Omnes Omnibus
@jl: I think they would work better from a tall tree or cliff face.
goblue72
@catclub: I hope so. Anything that is being led by Landrieu and Feinstein is sure to be an anti-progressive, corporatist ratf#ck. Neither of those two have done ANYTHING to earn the trust of the Democratic base.
Put another way, when Ted Kennedy cut a deal with the GOP, you could trust we were getting something out of it – he had earned it. But Landrieu or Feinstein? Forget about it. Check your wallets and head for the bomb shelters.
? Martin
@Violet: Yeah, the first month expectations were just stupidly optimistic.
Omnes Omnibus
@goblue72: I doubt that the bill will go anywhere because of the House. However, the fact that it is being introduced can be spun as Democrats being interested in fixing problems with the ACA. It gets spun as the law as whole is good, but there are a few problems and we are trying to fix them. No one ever argued that the ACA was the ultimate solution to our healthcare problems. Therefore, offering fixes isn’t a problem.
Citizen_X
@KG:
Yeah, but give the people of that town credit: they pretty much all said, “Well, that guy’s kinda fucked in the head.”
David Koch
@Omnes Omnibus: I could buy into that if the bill was coming from trusted quarters, but when it comes from a clown like feinstein it can only make one suspicious.
Omnes Omnibus
@David Koch: I’d agree that I actually trust Landrieu over Feinstein. But I agreed with Richard Mayhew on it. Also, it isn’t going to pass the House even it gets through the Senate. Dems need to spin it as trying to fix a minor problem that has come up in massive law.
David Koch
@Omnes Omnibus: I just read Mayhew’s post and it actually sounds good. like a broken clock, feinstein stumbles on to the right position every now and then.
now if Mayhew could only repost his analysis around the blogosphere, cuz you know if this gets adopted the nihilists blogs will start screaming “kill the bill II”
Omnes Omnibus
@David Koch: DiFi is ultimately a Democrat. Not a good one. But she is one. Landrieu, I think, is as progressive as can be elected in Louisiana right now.
Edited slighty
Mandalay
With all due respect, who cares? To dig up comparative data on what Massachusetts did in 2006 is pretty meaningless (as your link points out). The Administration had predicted half a million people would have signed up by now, and only 106,000 have done so. I appreciate your efforts here, and I really want the ACA to succeed as well, but putting lipstick on a pig is not helpful.
ETA healthcare.gov is down right now for “scheduled maintenance”.
Omnes Omnibus
@Mandalay: The score in the first quarter of a football game is necessarily predictive of the final score, right?
Mandalay
@Omnes Omnibus: Your analogy fails miserably. The enrollment numbers are currently only 21% of the Administration’s own prediction. That’s the problem, and to ignore that reality, or attempt to gloss over it, is counterproductive.
BJ has rightly been guffawing at how the Republicans were claiming victory in Va because they only lost by 3%. Let’s not emulate their approach by bragging about the enrollment numbers.
Omnes Omnibus
@Mandalay: Jesus fucking Christ. What are the numbers that matter? The monthly figures or the number that sign up by the deadline? I say the deadline numbers matter. Anything else is mid game scores.
mclaren
@Omnes Omnibus:
Exactamundo. The Obama administration issued overly rosy predictions of sign-up numbers and that doesn’t matter, because the sign-ups are on-track regardless. Moreover, as others have pointed out, the federal subsidies absolutely positively guarantee that there cannot be an insurance death spiral even if the state exchanges don’t meet their quotas. So the whole bullshit about “this is the start of a death spiral” and “Obamacare is unraveling” are utter bilge.
Mandalay
@Omnes Omnibus:
Both matter. The intense political heat the Administration is facing at the moment over the ACA is directly because of the low enrollment numbers. So the monthly figure you dismiss really matters. A lot. Democrats as well as Republicans are now pressuring the Administration to move the goalposts.
To argue that all that matters is the end result is absurd, and smacks of a complete detachment from reality.
Mandalay
@mclaren:
Of course it matters. It gives opponents of the ACA a perfect pretext to portray the whole enterprise as a clusterfuck, and giving “overly rosy predictions of sign-up numbers” was a blunder.
Maybe so, but try making that argument to folks who are trying to sign up. You won’t get very far.
Omnes Omnibus
@Mandalay: Oh good god. The ACA ultimately needs X number of people involved. If it gets them in October, November, or February it doesn’t matter. In the short term, the day to day, month to month numbers have an effect. In the long run, they don’t matter. Try not to reason like a finance MBA candidate.
Ripley
Perfect pretexts, dudebros. All about the perfect pretexts.
Richard Mayhew
@mclaren: do you ever get tired of masteurbating in public while fantasizing about Medicare for all. That was not passable in 2009(see vote count for public option and then subtract an arbitrary but large number) so if the choice is a significant but not perfect improvement that creates new stakeholders for further future change or the status quo of 2009, I will take the improvement
Richard Mayhew
@Mandalay: re who cares/lipstick on pig
Massachusetts is the relevant comparable and we know the system basically works in Mass. If PPACA is mirroring the initial Mass experience then the sky is most likely not falling… the projection issue is just that a projection issue not a fatal flaw
Matt McIrvin
@Richard Mayhew: I think the two of you may be talking past each other: you’re talking about the financial viability of the system, and Mandalay is talking about its political vulnerability. The Massachusetts system didn’t start out with most of the population convinced it was a terrible idea and the controlling faction in the House actively trying to destroy it; there was no chance that it would be politically gutted before it even had an opportunity to work. When I go on a generally liberal site like Talking Points Memo, and half the headlines there have words like “woeful” and “calamitous” in them and generally sound like Fox News, there’s a political problem.
NonyNony
@Richard Mayhew:
Richard – you’re arguing from a position of “will this legislation be effective for getting the job done”. Mandalay is arguing from a position of “will this policy get killed because of politics before it can do any good”. You’re going to talk past each other on this because Mandalay is freaking out (possibly with good reason) over the political ammunition that was unnecessarily handed to Republicans over the roll-out, even if ultimately it all works out in the end as you say it looks like it’s on a path to.
But I look back at the last 6 years and see one long string of Democrats handing political ammunition over to Republicans to use and the Republicans consistently shooting themselves in the foot before they can use it effectively.
I do want to know whose ass they pulled those half million enrollment by this time numbers out of. Because it really sounds like that’s where the came from – out of someone’s ass. If the only relevant model for this is MA’s rollout, and the Federal rollout is roughly on par or just slightly under MA’s rollout at this point, then who the FUCK thought that the Federales would be processing enrollments FIVE TIMES FASTER than MA did when they rolled theirs out? That’s just stupid – and actually suggests that the people involved may never have had to be part of an open enrollment process for insurance in their lives.
Enhanced Voting Techniques
@KG: That guy just can say he wants a Drone Hunting License to protect his meth lab.
Enhanced Voting Techniques
@mclaren:
The engineers at Boeing beg to differ:
http://www.wired.com/autopia/2010/03/boeing-787-passes-incredible-wing-flex-test/
Enhanced Voting Techniques
So riddle me this: why would anyone be racing to enroll right now when you can’t get the policy until next January? I am in the same boat – on Cobra right now and need to get my own health care for at lest three months. But seems a bit of waste of time signing up at the moment.
Gretchen
@Tommy: I’m with you. I spent 20 minutes setting up an account for my son, and then was faced with a choice of about 20 plans. I didn’t pick one right away! I’ll wait until the two of us have nothing better to do than spend a couple of hours together sorting through insurance plans, and when that doesn’t happen, we’ll make a quick decision in late December. Now that I realize that everyone else is doing the same thing, I’d better do it in early December to beat the rush. But we absolutely, positively will buy something by Jan 1, and I’m guessing that so will everyone else who bothered to set up an account. My worry is that all the media focus on the problems will discourage people from looking at all, and I think that’s the intent. The last way to destroy Obamacare is to keep people from signing up, and they’re working their hardest at it. I have a friend, a flaming liberal, who is exactly the person this was meant for. She’s in her 50’s, preexisting condition, works 3 low-wage part-time jobs that don’t provide insurance. She hasn’t looked at the exchanges because “I heard they don’t work” and was about to renew her crappy individual account.
Richard Mayhew
@Gretchen:
1) If you want coverage for January 1st, you need to send money in by December 15th.
2) Get your friend to a navigator ASAP.
3) Who buys early — those who know that they really need coverage and are nervous that delay will imperil them.
Gretchen
Thanks, Richard! I’lll do that.
Another Holocene Human
@Matt McIrvin: Except that Mandalay has no credibility with me talking about politics. (He’s almost as reliably wrong as young Mr. Crystal.) Just a truncheon to whack the president with. He doesn’t care about anything else.
I do wonder why HHS would offer such silly figures. DOT is smarter than that. And this isn’t Sebelius’ only misstep. (For one thing, hiding the full cost plan info from browsers in the initial rollout.) Meh.
Uncle Ebeneezer
Richard (or others here): what is your take on the 1 year extension that Obama is supposedly about to announce? Alot of people are quick to jump on this as another example of spineless Obama/this will kill the plan etc.