The enrollment model for Obamacare is deadline driven. The pre-launch model was that there would be early interest and shopping but very little buying in October, a bit more buying in November as people who knew that they were in desperate situations decided to knock out a stresser by purchasing a plan that would be effective 1/1/14, and then a mad dash from Cyber Monday to December 15th for 1/1/14 healthcare.
And then there would be a quiet three weeks as no one would shop over Christmas and the New Year’s. A minibump for 2/1 coverage was expected the week before 1/15, and then quiet again until Valentine’s Day as people bought coverage effective March 1st. After Valentine’s Day, there would be a month long enrollment extravaganza that would make December look like a light work-out as the mandate would force the procrastinators to get insurance or pay the penalty by March 15th for April 1st coverage. The final expectation is that the demographic mix would look bad in the first couple of months as people who know that they are in significant need of health insurance would be the first to sign up, but healthier people would procrastinate until forced to make a decision.
That was the basic model. And it is a reasonable extrapolation of the Massachusetts’ experience. The roll-out clusterfuck shifted some of the early enrollment to December but it looks reasonable. If anything the off-peak enrollment is coming in higher than I would have expected. For instance, Conneticutt is processing a thousand enrollments a day post Dec. 23 deadline. That is roughly a third of their average December enrollment without a deadline pressure. Brainwrap passes along Nevada numbers that show the post Dec. 23 pace is similar to the pre-Dec. 23 pace.
Additionally the early state level enrollment demographics are solid according to TPM:
Here are the percentages of enrollees between ages 18 and 34, from six states, including California, the most populous:
- California: 21 percent
- Colorado: 18 percent
- Kentucky: 32 percent*
- Maryland: 25 percent
- Rhode Island: 20 percent
- Washington: 18 percent
senior adinistration official described the Massachusetts experience to TPM, when that state rolled out its health reform law in 2007. During each of the first three months of enrollment, young adults made up 17, 17 and 24 percent respectively of the sign-ups, a pretty close match to the proportions in these states under Obamacare.
But in each of the final three months, young adults accounted for between 34, 36, and 34 percent, respectively, a significant jump.
We saw in December that procrastination is a powerful force and only deadlines will get a lot of people to make a decision. However, there seems to be a fairly large cohort of motivated slackers who did not get 1/1 coverage but are actively seeking out 2/1 coverage and if that holds, the January and February numbers will be large. I don’t think they will be December enrollment numbers but these months should blow November out of the water. And then we hit the March manic mandate deadline.
aimai
I’m procrastinting right now! Ask me how!
jheartney
We enrolled in early December, but not due to procrastination. We had an (apparently) nonrecoverable erroneous entry in our application data, and it wasn’t till December that the website provided tools for trashing your old application and starting over. Once we got enrolled, Anthem took forever to acknowledge our application, and required an hour waiting on a phone line before they’d give us a way of paying the first month’s premium. Now, a month after our enrollment, our bank says they have yet to process our payment (another hour and a half wait for Anthem phone help revealed that they have our info, have enrolled us, but haven’t got to processing the payment for some reason). Ah, that legendary private enterprise efficiency.
dmsilev
@aimai: If you don’t mind, I’ll ask you later.
aimai
@dmsilev: Can I get back to you on that?
jheartney
@aimai: Had a roommate who was going to join a procrastinator’s club, but he never got around to it.
Fair Economist
Between the complexity of applications, the long period the website wasn’t functional, and the crush at the end, there may be a lot of people who were trying to get in by the Dec 23 deadline but couldn’t quite make it. The lull (or lack thereof) after 1/15 may be more telling.
ranchandsyrup
Way to take the Longview, Richard.
Certified Mutant Enemy
Here’s an appropriate song…
Citizen_X
@jheartney:
[Shakes fist at sky] OBAMAAAAAAA!
The Pale Scot
Here in FL I am trying to help younger family members enroll. They make less than 16,000 which seems is the point where they would be eligible for tax credits. Since FL hasn’t expanded Medicaid they are screwed. I have read that supposedly you can overestimate your expected income to qualify for subsidies with no penalty. I can think up several ways to inflate their income but since the subsidy is a tax credit I don’t see how to qualify for it when doing their tax returns unless this tax credit is going to be implemented differently than any other. Mr. Mayhew have you seen any info that delineates how the IRS is going to implement the subsidy.
MattR
@Citizen_X: My company just switched us over to Anthem and both their website and phone support is atrocious. Obviously this is all Obama’s fault.
Linda Featheringill
Hey baby what’s your hurry
Relax and don’t you worry
We’re gonna be insured
We’re on the road to Obamacare – that’s safe to say
But let’s make all the stops along the way
[with apologies to Bergman, Bergman, and Spence]
dmsilev
@aimai: Sorry for the delay in responding. Can I take a rain check?
RaflW
Any idea how we’ll know how many people ended up doing like me, which was buying a non-exchange but ACA compliant plan direct from an insurer? The plan I got is better for my specific wants & budget*, so I skipped MNSure.
And my partner just decided to accept the roughly comparable replacement plan from his insurer after the old non-ACA plan was (horrors!) cancelled. So he’s not a MNSure statistic either.
Granted, we were both insured before ACA, but we both have better, cheaper plans now. We’re ACA successes who may never get counted.
*I make too much for a subsidy. My partner, as a grad student (ie temporarily poor & we’re not married) could probably have gotten Medicaid but flat out refused. Which was fine with me.
Villago Delenda Est
Totally OT, but apparently the GOP 2016 clown car can be a bit smaller, according to Noisemax:
Dr. Ben Carson: I Will Not Run for President
amk
I’ll get a round tuit.
Villago Delenda Est
Totally geek take on this:
“LFG for Sha of Procrastination…perhaps later this afternoon…”
Mike in NC
I emailed a note to the local paper after reading letter after letter from FOX News-watching morons claiming that Obamacare was going to be much worse than Stalin’s Gulag. I explained how much money we were going to be saving under ACA. And they actually printed it.
Now I suppose I can look forward to some hate mail and maybe even a death threat.
Villago Delenda Est
Copied from Powder Blue Satan:
Tumbrels are needed for these shitstains. To include The Large One.
dmsilev
@Villago Delenda Est: And apparently Tough Guy Christie has decided running away is the best approach:
MomSense
@The Pale Scot:
In my experience with the tax credit, it is applied to my insurance premium each month.
Another Holocene Human
@RaflW: My wife bought directly because she’s impatient and the buy button within healthcare.gov wasn’t work.
However, I think some data is trickling out about off-exchange enrollments direct to insurers. Many states will be requiring this info to be reported anyway. In about six months we should have some notion how much or how little the ranks of the uninsured have shrunk.
The angry red states with high poverty and low moral fiber that refused Medicaid will probably be even worse than they were before.
We need a new admin here in Florida because SCHIP is a fucking joke. It should NOT take that long to process applications to get kids into Florida Healthy Kids. By making it onerous they’re guaranteeing that only determined gov’t program users will sign up, while destitute and neglected kids get nada and working poor overpay through employers b/c they’re too busy to keep on those jokers. SCHIP is supposed to be available to EVERY child in Florida no matter the income.
Another Holocene Human
@dmsilev: Brave, brave, brave!
Man, I guess they were right: bullies ARE cowards. You just have to find out what it is specifically they’re afraid of (obviously not YOU) and unload in front of witnesses.
Violet
Richard, do you know how much the healthcare law has affected the ability of people who are on Medicare to get supplemental insurance? A friend of a friend is 66 and apparently got turned down by five health insurance providers due to her pre-existing health issues. I told my friend that couldn’t happen but then found out her friend was 66 and on Medicare. I didn’t know if the new healthcare law affects that demographic. Any info? Is it state by state?
chopper
@dmsilev:
oh, this is gonna be a fun week.
Villago Delenda Est
@Villago Delenda Est:
Powder Blue Satan’s source for that blockquote, I might add, is NorthJersey.com (via TPM), and the obviously on the ball Shawn Boburg of NorthJersey.com who should get a medal for this.
Baud
@Villago Delenda Est:
TPM can be infuriating sometimes, especially with their headlines and concern trolling, but they are indispensable.
The Pale Scot
@MomSense: Thnx for the info
AnotherBruce
Not just TPM, there is a link to the WSJ, with pretty much the same info. Christie is cooked.
Violet
This Christie bridge smoking gun documents story has bumped the Gates story off the top of Google News. I think Bob Woodward is going to be disappointed. New York media is going to be all over the Christie story. It’s got everything they love–gossip, revenge, affecting them personally, downfall of a powerful man.
Villago Delenda Est
I think you can stick a very large serving fork into Christie. He’s done.
WereBear
In my experience, it takes a compelling reason (I need treatment now!) to get people to make any decision.
There is nothing most people hate more than decisions!
dmsilev
@AnotherBruce: Also the Times, plus apparently a bunch of Jersey local media outlets.
I am curious as to what is in the redacted bits.
dmsilev
@Villago Delenda Est:
I believe that Internet Tradition requires using a rusty pitchfork.
Villago Delenda Est
@WereBear:
Most people are very uncomfortable with making a decision without having a lot of facts to base it on, and wading through health care insurance (or any insurance detail, for that matter) is intimidating at best.
So, naturally, they procrastinate…and at the same time don’t go into the minutia of it, which they most likely will not be able to parse to make a decision they’re confident in.
Unfortunately, a lot of people bank on that tendency, when offering the choices.
dmsilev
@Violet:
Almost everything. There’s no sex, at least so far as we know.
WereBear
I arrived as a kid in Florida in the late 1960’s. Even then, it was pretty quickly obvious to me that Florida’s attitude to residents was: Shut up and go away, your lives are costing us money. Rich tourists… that is who Florida loves.
Villago Delenda Est
@dmsilev:
Let’s hope it stays that way, once you get into that, there are mental images that are most disturbing.
AnotherBruce
The thing that’s really going to blow this up is the sheer venality of the Christie administration officials. It’s every bit as mean and petty as the Nixon administration during the Watergate era.
Violet
@dmsilev: No sex yet. Christie’s senior staffer Bridget Anne Kelly is young and cute. And just look how Christie is looking at her in the picture at the top of this story.
chopper
@Villago Delenda Est:
from your keyboard to god’s monitor. i’m not sure tho, gov. krispy could get through this. he’s hunkering down right now trying to figure it out.
jayboat
She’s got a ‘look’ about her in that photo…
future faux spokesmodel, cough cough
gonna reserve more comment for now because I am sure we are gonna see a lot of Bridget Anne Kelly in the coming days.
J R in WV
@Villago Delenda Est:
Who>?? Can someone I’ve never heard of run for President, and win? ‘Cause I watch the political news some, and never heard of this guy.
Oh, wait, is he a fundy xian wing-nut? ‘Cause I avoid learning about fallacies. That would do it.
@aimai:
Tomorrow, I’ll email you. I got my truck stuck in some not-yet-frozen mud yesterday, and I need to see if the tractor will start so I can push it out. If the tractor starts, after lunch.
Scamp Dog
I’m one of the people who missed the deadline for January 1st coverage, but I got signed up over the weekend. The snag that slowed me down was the need to be denied Medicaid to qualify for the tax credit.
On Saturday I got a call from Connect for Health Colorado, telling me the denial had come through, and would I like to complete the application process? Yes, I would! It took a bit less than an hour, since I already knew which plan I wanted.
So I’ll be insured for the first time in nine years. I’ll have to figure out how to stump up an extra $375 a month, but that’s a higher class problem than I had before.
Stella B
@The Pale Scot: No problem. The tax credit can be paid directly to the insurance company and your friend will be reponsible for the balance. Also, they will get cost sharing and have a 6% co-pay. It’ll be a little bit more expensive than Medicaid.
Patricia Kayden
The figures for young people look pretty good. Gosh darn it, this Obamacare thingy might just work out after all.
Avi
I had to trash my application repeatedly before I could get correct income info into the application (and after all that, I decided to just to front the premiums and file for the credit with my 2014 taxes). I was “initially enrolled” in my new plan on December 13. I made my binder payment on December 30—the first day Blue Cross would accept it—and now I’m waiting for an ID number so I can create an online account and print a card.
Meanwhile, Aetna sent me a January bill for the plan that they cancelled because PPACA (and that cost twice what I pay now). At no point did they send me a letter rescinding the cancellation notice. I have since told them to fvck off, and they have graciously agreed to do so.
rikyrah
you know I’m with him.
been saying for awhile that the DNC needs to be camped out in Kentucky right now, making ad after ad with nothing but WHITE working class/poor folks that NOW have healthcare thanks to Obamacare. And they need to play these ads around the clock in every state with a GOP Governor that refuses to expand Medicaid.
Final statement of the ad:
WHy do THEY have healthcare and you don’t?
Because their Governor is a Democrat and yours is a Republican.
……………..
Steve Beshear: Don’t fear the politics of Obamacare, Dems
By Greg Sargent
January 8 at 12:11 pm
The rollout of Obamacare in Kentucky may represent the most interesting experiment in the politics of health care in the country right now. Dem governor Steve Beshear is perhaps the most outspoken defender of the Affordable Care Act in the south. This, in a deep red state where the reform known as “Obamacare” is deeply unpopular; where the leading foe of the President’s agenda is on the ballot this year; and where the need for reform is urgent.
In an interview today, Beshear offered fellow Dems — red state and otherwise — some startling advice: Stand up for Obamacare because it’s the right thing to do. What’s more, Beshear insists, Republicans are wrong: the health law will be a political positive for Dems next fall.
“We’re doing the right thing,” Beshear told me. “That’s the most important point here. The people of America, and the people of Kentucky, deserve access to affordable health care. For the first time in the history of this country, we have a tool that allows us to accomplish this goal.”
Republicans and some pundits will scoff at the idea that Dems — particularly in red states — should stand up for Obamacare. And it’s true that polls show Obamacare — and the president — with a woefully low approval rating in Kentucky. Meanwhile, Republicans are banking on continuing headlines about canceled plans and higher premiums — perhaps followed by other problems.
Asked to respond, Beshear urged a longer view. “This issue is going to look a lot different in November 2014 than it looks today,” he said. “By November 2014, these exchanges will be working smoothly, and the world will not have come to an end. The ACA doesn’t affect 80 percent. By November of next year, they are going to know that. Right now some are afraid because of misinformation. By November they will know it’s not going to do anything to them. The other 20 percent are going to be happy, for the most part, with what they find.”
“In general this issue is going to be a winner for Democrats by November of 2014 — whether you’re in a red state or a blue state,” Beshear said.
http://www.washingtonpost.com/blogs/plum-line/wp/2014/01/08/steve-beshear-dont-fear-the-politics-of-obamacare-dems/
Mnemosyne
@rikyrah:
Why aren’t you writing commercials for the DNC, again? :-)
I think they also need a “This is What Obamacare Looks Like” series. The guy whose premiums went down at work. The cancer survivor who finally got coverage. The college student covered by their parent’s plan. The family who has a child with a chronic illness who can now get insurance.
cosima
We had our daughter sign up when she was home for the holidays. I sent her a link to healthcare.gov on October 1st & prodded her a couple of times, but she just couldn’t be arsed. Procrastination on her part, most likely due to a combination of her age and the fact that we were paying for her insurance, so no worries, mate!
So, we signed her up for a plan through Moda that is $200/month cheaper than the COBRA plan of my husband’s that she has been on and that will run out in March. We are expats now, living in the UK, and no longer have a US insurance plan to add her on to. We also got her a fairly great dental plan for less than $40/month — dental was not a COBRA option for us/her, so she’s been without for a year (I had her go to the dentist to get everything under the sun checked/filled/cleaned right up until hubby’s last day of work). Now we are waiting for Moda to get back to us with a payment option (we’d like to do a monthly direct debit for her costs) with a Feb start date. They finally sent an email yesterday saying we’re in the queue to have our questions answered. We signed up around the 20th of December, the confirmation of coverage arrived via email around Dec 30th, and we phoned them that same day to get the payment issues sorted with no luck. We were told to email billing, and that’s what we did.
We are crossing our fingers that when our daughter graduates from university this spring that she will find a job that has insurance, but if not she is at least covered. Well, one hopes that she is.
On another somewhat related note… Today I was at a friend’s house while her Polish cleaner was there. She introduced us, we chatted over coffee/tea, and the talk moved to health care. She is one of the recent influx of Eastern European workers that grab headlines so often here. Anyway, it sounds like all of her siblings — 3 brothers & 1 sister — are all now living & working in the UK somewhere and her parents visit often. They are amazed at the return on tax investment here, it sounds like Poland is little changed from post-Communist times (no bread lines, but even business owners such as her parents have little to show for it), particularly in terms of health care. She was telling us about some concerts that she & friends had put on in a few cities in Scotland to raise money for the sick child of a friend, sending the money back to her in Poland. I said “just like people do in the U.S.!” It’s a sad, sad thing that we can be/are comparable to Poland in that way. Nearly 30 years ago I visited the USSR & Poland, and there were the bread lines & armed soldiers everywhere & concrete block housing. I would love to sit and talk more with Magda about the changes, or lack thereof.
Go U.S.A. — musical fundraisers to treat sick children, just like in Poland! Our daughter earns less than $10,000/year, doing a lot of crap jobs while going to school full-time. She could not get any subsidies — because she’s in Alaska where the red governor reigns — and there is little chance that she’d have been able to come up with an extra $400/month to pay for health & dental care.
Anyway, that’s our ACA experience for what it’s worth.