Obamacare On Track to Beat Enrollment Estimates


A lot of people are closely watching the enrollment numbers for the Affordable Care Act exchanges, ready to quip and pounce on the administration for falling behind a quasi-goal of enrolling 7 million Americans by 2013. The pace of enrollment has been poured over by the media to try to find ways to suggest that the administration is falling short, and by extension, Obamacare is doomed.

While the 7 million figure is a CBO estimate rather than an explicit Administration goal, the bloodhounds in the media are likely to come up empty even in its chase. A whole lot of splash was made from numbers released yesterday by HHS which saw the federal exchanges quadruple in November their October haul. Still, argued the media's tea-leaf readers, the total is only 365,000 enrolled two months into the process between the state and federal exchanges, and the pace is not enough to drag the numbers to 7 million by the March 31 deadline for open enrollment.

The media's provocateurs are wrong on two fronts: first, the assumption that the "pace" is linear (meaning, you can take an average of the past and extend that linearly to get an estimate of future enrollment) is completely bunk. Linear calculations would indicate an average enrollment of about 182,500 per month, which would mean roughly 1.3 million by the end of the March 31 deadline. That would be horrendous indeed.

However, enrollment rates always spike the closer we get to the deadline. The pace is closer to exponential than linear - meaning a better estimate would be to assume each month the numbers go up by a certain multiple. In October, the enrollment figure (state+federal) stood at roughly 100,000, and in November it was roughly 2.5 times that. If that pattern holds, 650,000 will enroll this month, etc. But that won't hold forever either. We are likely to see a spike this month for people wanting coverage to start January 1, and another spike in March as people hurry in before open enrollment closes.

Interest remains overwhelming. Just last week, after the website fixes went live, 3.7 million visitors rushed to Healthcare.gov, which held up to the dismay of the law's right wing critics and its left wing deserters alike.

Which brings us to the second reason the readers of the tea-leaves are pathetically wrong. The 365,000 figure only counts those who have already chosen a plan and been enrolled. It does not count the roughly 1.9 million people who have applied and received eligibility verification from the exchanges but have not yet picked a plan. Picking the plan is only a matter of decision making from the point of eligibility determination and completion of the application. Add that to the 365,000 and the number jumps to 2.3 million. Even on a linear scale, that pace will put the enrollment estimates to almost exactly 7 million by the end of March.

None of this is to say anything of the nearly 1 million people who have been deemed eligible for the Medicaid expansion in states that have chosen to accept the fully federally funded expansion.

Conservatives gave the 'Obamacare' moniker to the Affordable Care Act in an effort to berate and ridicule it. But now, it is turning out to be an apt nickname for the law in more ways than one. Not only is it this president's signature domestic policy achievement and his lasting legacy, but Obamacare is showing the kind of resiliency its namesake himself is known for. Both the Obama presidency and Obamacare have survived countless conservative attempts to dismantle, unprecedented conservative obstructionism, liberal poutrage of not-enough-ism, and somehow, both keep shining through, surviving, and thriving.

Actually, not somehow. We know exactly how. By keeping set on the goal of making lives better for ordinary people, working hard, and never giving up into the naysaying, condescension, and obstrucionism.